NPIMap

Organization Active NPI

Madison Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Madison, AL
National Provider Identifier
1184935959
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
MADISON PEDIATRIC DENTISTRY LLC
Practice address
7559 Highway 72 W
Suite C7/C8
Madison, AL 35758-8811
Phone
(256) 527-4590
Fax
(256) 890-4293
NPI assigned
Jun 27, 2010
Last updated
Apr 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Wesley Moffett, D.M.D.
Title
Member
Phone
(205) 792-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

7559 Highway 72 W
Suite C7/C8
Madison, AL 35758-8811

Mailing address

7559 Highway 72 W
Madison, AL 35758-8811
Phone (256) 527-4590

National Provider Directory

National Provider Directory

Locations

7559 Highway 72 W
Ste C7C8
Madison, AL 35758
Phone (256) 527-4590

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365984000000",
    "number": "1184935959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7559 HIGHWAY 72 W",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588811",
            "telephone_number": "256-527-4590",
            "fax_number": "256-890-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7559 HIGHWAY 72 W",
            "address_2": "SUITE C7/C8",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588811",
            "telephone_number": "256-527-4590",
            "fax_number": "256-890-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-27",
        "last_updated": "2013-04-15",
        "status": "A",
        "authorized_official_last_name": "MOFFETT",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "205-792-0003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.