NPIMap

Organization Active NPI

S.M. Mahan L.L.C

  • General Practice Dentistry
  • Brierfield, AL
National Provider Identifier
1336314160
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2722 Issued in AL
Legal business name
S.M. MAHAN L.L.C
Practice address
19330 Highway 139
Brierfield, AL 35035-3658
Phone
(205) 665-2723
Fax
(205) 665-1037
NPI assigned
Apr 23, 2008
Last updated
Apr 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Dr. Stanley Michael Mahan Jr., D.M.D
Title
Dentist/Owner
Phone
(205) 665-2723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2722 AL Primary

Addresses

Primary practice location

19330 Highway 139
Brierfield, AL 35035-3658

Mailing address

PO Box 100
Brierfield, AL 35035-0100
Phone (205) 665-2723

Other identifiers 1

IdentifierTypeStateIssuer
529919020MedicaidAL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1336314160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "BRIERFIELD",
            "state": "AL",
            "postal_code": "350350100",
            "telephone_number": "205-665-2723",
            "fax_number": "205-665-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19330 HIGHWAY 139",
            "city": "BRIERFIELD",
            "state": "AL",
            "postal_code": "350353658",
            "telephone_number": "205-665-2723",
            "fax_number": "205-665-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.M. MAHAN L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "205-665-2723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "2722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529919020",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brierfield, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.