Shelton Beach Dental Center Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3152 Issued in AL

Legal business name

SHELTON BEACH DENTAL CENTER INC

Practice address

623 Highway 43 S
Suite a
Saraland, AL 36571-3633

Phone

(251) 675-7630

Fax

(251) 675-7637

NPI assigned

Feb 5, 2014

Last updated

Feb 5, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William R Bruner, D.M.D

Title

Dentist

Phone

(251) 675-6730

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1205250727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11474",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366710474",
            "telephone_number": "251-675-7630",
            "fax_number": "251-675-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 HIGHWAY 43 S",
            "address_2": "SUITE A",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365713633",
            "telephone_number": "251-675-7630",
            "fax_number": "251-675-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTON BEACH DENTAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "BRUNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "251-675-6730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saraland Dental Center
• Saraland Family Pract PC
• Saraland Physical Therapy Services Inc
• Seton Medical Management Inc.
• Keragan Elizabeth Sheffield, AU.D.
• Telina Michelle Sikes-Doggett, DNP, AGNP-C
• Lillian Phann Sisavanh
• Myra Crossley Slayton, CCC-SLP
• Christie Smith, LPC
• Keagan Nicole Smith, OTR/L

• General Practice Dentistry in Saraland, AL
• Providers in Saraland, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.