Pediatric Dental Associates

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTAL ASSOCIATES

Practice address

404 S 5TH St
Gadsden, AL 35901-5102

Phone

(256) 546-4604

Fax

(256) 546-4674

NPI assigned

Nov 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael A Holmes Sr., DDS

Title

President

Phone

(256) 546-4604

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1265612469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S 5TH ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015102",
            "telephone_number": "256-546-4604",
            "fax_number": "256-546-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S 5TH ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015102",
            "telephone_number": "256-546-4604",
            "fax_number": "256-546-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-546-4604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51516050",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Leigh Payne, LPC, CAC
• Pearle Vision Center
• Sonya L Pearson
• Zerrin C Pearson, CRNA
• Demi Lee Peck, OTR/L
• Pediatric Dentistry East P.C.
• John C Peeden, CRNA
• Pegasus Emergency Group Gadsden, LLC
• Kathryn Peilen, MD
• Florencia Andrea Pereira Zigante, MD

• All providers in Gadsden, AL
• Pediatric Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.