Locust Fork Family Dentistry, Inc.

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

Organization subpart

No

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

Authorized official

Name

Rachel G Osborne, DMD

Title

Owner/Operator

Phone

(205) 681-3050

Specialties & licenses 1

Addresses

Locations

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": []
}

• Johnny Hoyt Cleveland, RPH
• Locust Fork Pharmacy, LLC
• Jeffery Scott Neaves, LPC, NCC
• Rachel Glynn Osborne, D.M.D.
• Margaret Gray Pond, DMD
• Whitney Breanna Waid

• All providers in Locust Fork, AL
• General Practice Dentistry in Alabama

• 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.