Organization Active NPI

Dentaid Dental Center PC

  • General Practice Dentistry
  • Mobile, AL
National Provider Identifier
1316088537
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAID DENTAL CENTER PC
Practice address
2727 Pleasant Valley Rd
Mobile, AL 36606-2162
Phone
(251) 473-5705
Fax
(251) 479-4709
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Roger A Fleshman
Title
Cfo
Phone
(504) 737-0197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2727 Pleasant Valley Rd
Mobile, AL 36606-2162

Mailing address

2727 Pleasant Valley Rd
Mobile, AL 36606-2162
Phone (251) 473-5705

Other names 1

  • Kids Aid of Mobile PC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316088537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 PLEASANT VALLEY RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366062162",
            "telephone_number": "251-473-5705",
            "fax_number": "251-479-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 PLEASANT VALLEY RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366062162",
            "telephone_number": "251-473-5705",
            "fax_number": "251-479-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAID DENTAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLESHMAN",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "504-737-0197",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Aid of Mobile PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.