Tuscaloosa General Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5759 Issued in AL

Legal business name

TUSCALOOSA GENERAL DENTISTRY

Practice address

631 Helen Keller Blvd
Suite 200
Tuscaloosa, AL 35404-2983

Phone

(205) 553-4477

Fax

(205) 553-0202

NPI assigned

Jul 15, 2010

Last updated

Sep 4, 2013By 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

Dr. John Terry Carlson Jr., DMDNPI 1801116041

Title

Owner, President

Phone

(205) 553-4477

Specialties & licenses 1

Addresses

Other names 1

• John T. Carlson, Jr., D.M.D,, P.C. Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Terry Carlson Jr., DMD

  • Dentist
  • Tuscaloosa, AL
  • NPI 1801116041
  NPD (past) Authorized official

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1376856625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 HELEN KELLER BLVD",
            "address_2": "SUITE 200",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042983",
            "telephone_number": "205-553-4477",
            "fax_number": "205-553-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 HELEN KELLER BLVD",
            "address_2": "SUITE 200",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042983",
            "telephone_number": "205-553-4477",
            "fax_number": "205-553-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSCALOOSA GENERAL DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TERRY",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "205-553-4477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John T. Carlson, Jr., D.M.D,, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• 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 Sep 4, 2013; 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.