NPIMap

Organization Active NPI

Stonecreek Dental of Alabama

Doing business as Diamond Smiles Homewood

  • Dental Clinic/Center
  • Homewood, AL
National Provider Identifier
1396406864
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STONECREEK DENTAL OF ALABAMA
Doing business as
Diamond Smiles Homewood
Practice address
112 Broadway St
Homewood, AL 35209-5312
Phone
(205) 847-1415
NPI assigned
Jan 6, 2022
Last updated
Jan 6, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
STONECREEK DENTAL OF ALABAMAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Authorized official

Name
Veronica Jackson
Title
Revenue Cycle Manager
Phone
(205) 538-5464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

112 Broadway St
Homewood, AL 35209-5312

Mailing address

112 Broadway St
Homewood, AL 35209-5312
Phone (205) 847-1415

Other identifiers 1

IdentifierTypeStateIssuer
0000OtherNONE

Other names 1

  • DIAMOND SMILES HOMEWOOD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stonecreek Dental of Alabama26 organizations share this tax ID, including this one
Part of
Stonecreek Dental of Alabama

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1396406864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BROADWAY ST",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352095312",
            "telephone_number": "205-847-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BROADWAY ST",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352095312",
            "telephone_number": "205-847-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONECREEK DENTAL OF ALABAMA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STONECREEK DENTAL OF ALABAMA",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "205-538-5464"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "0000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIAMOND SMILES HOMEWOOD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homewood, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.