NPIMap

Organization Active NPI

Children and Teen Dental Group of Alabama

Doing business as Trussville Pediatric Dentistry

  • Pediatric Dentistry
  • Trussville, AL
National Provider Identifier
1205401304
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CHILDREN AND TEEN DENTAL GROUP OF ALABAMA
Doing business as
Trussville Pediatric Dentistry
Practice address
4901 Deerfoot Pkwy Ste 101
Trussville, AL 35173-2697
Phone
(205) 655-1000
NPI assigned
May 21, 2021
Last updated
May 20, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDREN AND TEEN DENTAL GROUP OF ALABAMAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Authorized official

Name
Brian Smith
Title
Coo
Phone
(770) 231-5348

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

4901 Deerfoot Pkwy Ste 101
Trussville, AL 35173-2697

Mailing address

2300 Lakeview Pkwy Ste 250
Alpharetta, GA 30009-3954
Phone (727) 784-2721

Other names 2

  • Trussville Pediatric Dentistry Doing business as
  • Alabama Dental Sedation Other name

National Provider Directory

National Provider Directory
Tax ID family
Children and Teen Dental Group of Alabama7 organizations share this tax ID, including this one
Part of
Children and Teen Dental Group of Alabama

Other organizations with this tax ID 6

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

Locations

4901 Deerfoot Pkwy
#101
Trussville, AL 35173
Phone (205) 508-7135

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779235200000",
    "number": "1205401304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LAKEVIEW PKWY STE 250",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300093954",
            "telephone_number": "727-784-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 DEERFOOT PKWY STE 101",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351732697",
            "telephone_number": "205-655-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN AND TEEN DENTAL GROUP OF ALABAMA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN AND TEEN DENTAL GROUP OF ALABAMA",
        "enumeration_date": "2021-05-21",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-231-5348"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trussville Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alabama Dental Sedation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Trussville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.