North Mobile Dental Medicaid, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4781 Issued in AL

Legal business name

NORTH MOBILE DENTAL MEDICAID, LLC

Practice address

1064 Industrial Pkwy
Saraland, AL 36571-3720

Phone

(251) 675-4313

Fax

(251) 675-4355

NPI assigned

Sep 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Shonn M Farni, DMD

Title

Owner

Phone

(251) 675-4313

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1275840415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 INDUSTRIAL PKWY",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365713720",
            "telephone_number": "251-675-4313",
            "fax_number": "251-675-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 INDUSTRIAL PKWY",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365713720",
            "telephone_number": "251-675-4313",
            "fax_number": "251-675-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MOBILE DENTAL MEDICAID, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "FARNI",
        "authorized_official_first_name": "SHONN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-675-4313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "4781",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "4782",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "4784",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "5712",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Courtney McDaniel Nix, CRNP
• North Mobile Counseling Associates, LLC
• Northern Mobile Medical Diagnostics
• Northside,P.C.
• Christopher Alan O'Laire, D.C.
• Olaire Health Solutions, Inc
• One Coast Medical, Inc

• Dental Clinic/Center in Saraland, AL
• Providers in Saraland, AL by specialty
• Dental Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.