NPIMap

Organization Active NPI

Locust Fork Family Dentistry, Inc.

  • General Practice Dentistry
  • Locust Fork, AL
National Provider Identifier
1386158293
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5624 Issued in AL
Legal business name
LOCUST FORK FAMILY DENTISTRY, INC.
Practice address
29984 State Highway 79 Ste 300
Locust Fork, AL 35097-5877
Phone
(205) 681-3050
Fax
(844) 815-6428
NPI assigned
Nov 30, 2017
Last updated
Nov 30, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Authorized official

Name
Rachel G Osborne, DMDNPI 1457514499
Title
Owner/Operator
Phone
(205) 681-3050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5624 AL Primary

Addresses

Primary practice location

29984 State Highway 79 Ste 300
Locust Fork, AL 35097-5877

Mailing address

29984 State Highway 79 Ste 300
Locust Fork, AL 35097-5877
Phone (205) 681-3050

National Provider Directory

National Provider Directory

Locations

29984 State Highway 79
Ste 300
Locust Fork, AL 35097
Phone (205) 681-3050

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1386158293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29984 STATE HIGHWAY 79 STE 300",
            "city": "LOCUST FORK",
            "state": "AL",
            "postal_code": "350975877",
            "telephone_number": "205-681-3050",
            "fax_number": "844-815-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29984 STATE HIGHWAY 79 STE 300",
            "city": "LOCUST FORK",
            "state": "AL",
            "postal_code": "350975877",
            "telephone_number": "205-681-3050",
            "fax_number": "844-815-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOCUST FORK FAMILY DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "205-681-3050",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Fork, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.