NPIMap

Organization Active NPI

Bayou la Batre Area Health Development BD.Inc.

  • Dental Clinic/Center
  • Bayou la Batre, AL
National Provider Identifier
1194770669
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2006-293 Issued in AL
Legal business name
BAYOU LA BATRE AREA HEALTH DEVELOPMENT BD.INC.
Practice address
1340 North Wintzell Ave.
Bayou la Batre, AL 36509
Phone
(251) 824-2347
Fax
(251) 824-4337
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. James A. Holland, MPH
Title
Ceo
Phone
(251) 824-2174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2006-293 AL Primary

Addresses

Primary practice location

1340 North Wintzell Ave.
Bayou la Batre, AL 36509

Mailing address

PO Box 769
Bayou la Batre, AL 36509-0769
Phone (251) 824-2347

Other identifiers 1

IdentifierTypeStateIssuer
630000015MedicaidAL

Other names 1

  • Mostellar Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Midtown Mostellar Med CLN4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1194770669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769",
            "city": "BAYOU LA BATRE",
            "state": "AL",
            "postal_code": "365090769",
            "telephone_number": "251-824-2347",
            "fax_number": "251-824-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 NORTH WINTZELL AVE.",
            "city": "BAYOU LA BATRE",
            "state": "AL",
            "postal_code": "36509",
            "telephone_number": "251-824-2347",
            "fax_number": "251-824-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYOU LA BATRE AREA HEALTH DEVELOPMENT BD.INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-824-2174",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "2006-293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000015",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mostellar Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayou la Batre, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.