NPIMap

Organization Active NPI

Ruffner Mountain Restoration Dental, LLC

  • Dentist
  • Irondale, AL
National Provider Identifier
1376991885
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5637 Issued in AL
Legal business name
RUFFNER MOUNTAIN RESTORATION DENTAL, LLC
Practice address
2806 Ruffner Rd
202
Irondale, AL 35210-3926
Phone
(205) 851-4281
Fax
(205) 851-4282
NPI assigned
May 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Authorized official

Name
Dr. G Jari Rolle, DMD
Title
Dentist
Phone
(205) 851-4281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 5637 AL Primary

Addresses

Primary practice location

2806 Ruffner Rd
202
Irondale, AL 35210-3926

Mailing address

2806 Ruffner Rd
202
Irondale, AL 35210-3926
Phone (205) 851-4281

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1376991885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 RUFFNER RD",
            "address_2": "202",
            "city": "IRONDALE",
            "state": "AL",
            "postal_code": "352103926",
            "telephone_number": "205-851-4281",
            "fax_number": "205-851-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 RUFFNER RD",
            "address_2": "202",
            "city": "IRONDALE",
            "state": "AL",
            "postal_code": "352103926",
            "telephone_number": "205-851-4281",
            "fax_number": "205-851-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUFFNER MOUNTAIN RESTORATION DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "ROLLE",
        "authorized_official_first_name": "G JARI",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "205-851-4281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AL",
            "license": "5637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irondale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.