Genesis Dental Group Liberty Park

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GENESIS DENTAL GROUP LIBERTY PARK

Practice address

8000 Liberty Pkwy Ste 126
Vestavia, AL 35242-7565

Phone

(205) 879-6880

NPI assigned

Jun 6, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Pat Holt

Title

Administrator

Phone

(334) 676-2320

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496707200000",
    "number": "1255860045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 ZELDA CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062607",
            "telephone_number": "334-676-2320",
            "fax_number": "334-593-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 LIBERTY PKWY STE 126",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352427565",
            "telephone_number": "205-879-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS DENTAL GROUP LIBERTY PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2017-06-06",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-676-2320",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Davis Garner, MS OTR/L
• Aaron Garrett
• Samantha Garrett, BCBA
• Katelyn Garrison
• Ryan Gatza
• Gentry Pharmacy LLC (Gentry Health Mart Pharmacy)
• Hannah Stevenson George, ARNP
• Kyana George
• Johnny M Gibbs, M.D.
• Sarah Gibson, CRNP

• General Practice Dentistry in Vestavia, AL
• Providers in Vestavia, 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 Jun 6, 2017; 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.