Alabama Center for Oral Surgery and Dental Implants

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

ALABAMA CENTER FOR ORAL SURGERY AND DENTAL IMPLANTS

Practice address

188 N Foster St Ste 203
Dothan, AL 36303-4568

Phone

(334) 697-6453

NPI assigned

Jun 23, 2023

Last updated

Jun 23, 2023By 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

Donna Marie Davidson

Title

Office Manager

Phone

(850) 419-1244

Specialties & licenses 1

Addresses

Other names 1

• Barrett Tolley Other name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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.

• Bryan T Kendricks, D.M.D., M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Dothan, AL
  • NPI 1477087898
  Medicare reassignment NPD

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1417633520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 N FOSTER ST STE 203",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363034568",
            "telephone_number": "334-697-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 N FOSTER ST STE 203",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363034568",
            "telephone_number": "334-697-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALABAMA CENTER FOR ORAL SURGERY AND DENTAL IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-419-1244"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Barrett Tolley",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph Michael Al-Kirwi, DO, MS
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• Alabama CVS Pharmacy LLC (CVS Pharmacy #16800)
• Alabama CVS Pharmacy, L.L.C. (CVS Pharmacy #04878)
• Alabama CVS Pharmacy, L.L.C. (CVS Pharmacy #07179)
• Alabama Eye Physicians and Surgeons, P.C.
• Alabama Eye Surgery Center LLC

• Oral and Maxillofacial Surgery Clinic/Center in Dothan, AL
• Providers in Dothan, AL by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.