Jack Smalley Jr., D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AL 3757 Issued in AL

Practice address

1100 Fairfax Park
Tuscaloosa, AL 35406-2809

Phone

(205) 752-3506

Fax

(205) 752-3570

NPI assigned

Dec 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• LD-Northport, LLC

  dba North River Dental

  • Dental Clinic/Center
  • Tuscaloosa, AL
  • NPI 1114634730
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295710838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 FAIRFAX PARK",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062809",
            "telephone_number": "205-752-3506",
            "fax_number": "205-752-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 FAIRFAX PARK",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062809",
            "telephone_number": "205-752-3506",
            "fax_number": "205-752-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLEY",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL 3757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Josef Skonicki, MD
• Miranda E Slack
• Amber Slaughter, ALC
• Robert D Slaughter, MD
• Small Strides for Success, LLC (Fresh Outlook Counseling)
• Jessica K Smalley, CRNP
• SMC Elite Homecare Agency LLC
• Amanda Kasinecz Smedberg, CNP
• Angela Kynard Smelley, MD
• Smile Doctors of Alabama, PC

• General Practice Dentistry in Tuscaloosa, AL
• Providers in Tuscaloosa, 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 Jul 13, 2026; 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.