Secd Tallassee LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

6397 Issued in AL

Legal business name

SECD TALLASSEE LLC

Doing business as

Tallassee Family Dentistry

Practice address

1608 Gilmer Ave
Tallassee, AL 36078-2314

NPI assigned

Jun 5, 2017

Last updated

Jun 5, 2017By 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

Sara Northcutt, DDS

Title

Owner

Phone

(615) 319-4918

Specialties & licenses 1

Addresses

Other names 1

• Tallassee Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496620800000",
    "number": "1295264141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NATCHEZ VALLEY LN",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370644704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 GILMER AVE",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360782314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECD TALLASSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A",
        "authorized_official_last_name": "NORTHCUTT",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-319-4918",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "6397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tallassee Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Tallassee, AL
• Providers in Tallassee, 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 Jun 5, 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.