Magnolia Springs Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MAGNOLIA SPRINGS DENTAL, LLC

Practice address

12440 Magnolia Ave Ste 200
Magnolia Springs, AL 36555-6434

Phone

(251) 965-1773

NPI assigned

Sep 19, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Roberto Pischek, DMDNPI 1861985483

Title

Owner

Phone

(251) 213-1101

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Roberto Pischek

  • General Practice Dentistry
  • Magnolia Springs, AL
  • NPI 1861985483
  NPD Authorized official

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1295457901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12440 MAGNOLIA AVE STE 200",
            "city": "MAGNOLIA SPRINGS",
            "state": "AL",
            "postal_code": "365556434",
            "telephone_number": "251-965-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12440 MAGNOLIA AVE STE 200",
            "city": "MAGNOLIA SPRINGS",
            "state": "AL",
            "postal_code": "365556434",
            "telephone_number": "251-965-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA SPRINGS DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "PISCHEK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-213-1101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "1861985483",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Anne Brown, LGSW
• Joy Lymon
• Magnolia Springs Pediatrics PC
• Magnolia Springs Skin & Wellness Center PC LLC
• Matthew Roberto Pischek
• Robert Louis Rux, M.D.
• Albert Bedford Walker Jr., M.D

• Dental Clinic/Center in Magnolia Springs, AL
• Providers in Magnolia Springs, 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 19, 2022; 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.