Complete Dental North Madison LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5311 Issued in AL

Legal business name

COMPLETE DENTAL NORTH MADISON LLC

Practice address

120 W Dublin Dr
Suite. 202
Madison, AL 35758-3155

Phone

(256) 258-3883

Fax

(256) 464-5763

NPI assigned

Feb 16, 2016

Last updated

Feb 16, 2016By 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

Mrs. Teresa J Haake

Title

Billing Coordinator

Phone

(256) 258-3883

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1447619689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8141 US 72",
            "address_2": "SUITE. G",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35758",
            "telephone_number": "256-774-7228",
            "fax_number": "256-464-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W DUBLIN DR",
            "address_2": "SUITE. 202",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357583155",
            "telephone_number": "256-258-3883",
            "fax_number": "256-464-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE DENTAL NORTH MADISON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "HAAKE",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "256-258-3883",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Madison, AL
• Providers in Madison, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.