Organization Active NPI

JVM Dental Dba Northbank Family Dental

  • General Practice Dentistry
  • Tuscaloosa, AL
National Provider Identifier
1427624568
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JVM DENTAL DBA NORTHBANK FAMILY DENTAL
Practice address
1490 N Bank Pkwy Ste 130
Tuscaloosa, AL 35406-2431
Phone
(256) 710-5271
NPI assigned
May 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Authorized official

Name
Dr. Joshua A McClanahan, DMDNPI 1477916435
Title
Part-Owner Dentist
Phone
(256) 710-5271

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1490 N Bank Pkwy Ste 130
Tuscaloosa, AL 35406-2431

Mailing address

603 Whispering Pines LN
Helena, AL 35080-7528
Phone (256) 710-5271

Other identifiers 2

IdentifierTypeStateIssuer
1477916435MedicaidAL
1841793601MedicaidAL

National Provider Directory

National Provider Directory

Locations

1490 N Bank Pkwy
Ste 130
Tuscaloosa, AL 35406
Phone (205) 349-4716

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": "1622332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1427624568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 WHISPERING PINES LN",
            "city": "HELENA",
            "state": "AL",
            "postal_code": "350807528",
            "telephone_number": "256-710-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 N BANK PKWY STE 130",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062431",
            "telephone_number": "256-710-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JVM DENTAL DBA NORTHBANK FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-30",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "MCCLANAHAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PART-OWNER DENTIST",
        "authorized_official_telephone_number": "256-710-5271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477916435",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841793601",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.