NPIMap

Organization Active NPI

Stafford Dental PC

  • General Practice Dentistry
  • Jasper, AL
National Provider Identifier
1457732588
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3788 Issued in AL
Legal business name
STAFFORD DENTAL PC
Practice address
300 N Airport Rd
Ste 1
Jasper, AL 35504-2517
Phone
(205) 221-6700
Fax
(205) 221-9194
NPI assigned
Jun 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Dr. Myra Montgomery Stafford, DMDNPI 1255352233
Title
Owner
Phone
(205) 221-6700

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 3788 AL Primary

Addresses

Primary practice location

300 N Airport Rd
Ste 1
Jasper, AL 35504-2517

Mailing address

300 N Airport Rd
Ste 1
Jasper, AL 35504-2517
Phone (205) 221-6700

National Provider Directory

National Provider Directory

Locations

300 N Airport Rd
Ste 1
Jasper, AL 35504
Phone (205) 221-6700

Practitioners & affiliated clinicians

Practitioners 2

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": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1457732588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N AIRPORT RD",
            "address_2": "STE 1",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355042517",
            "telephone_number": "205-221-6700",
            "fax_number": "205-221-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N AIRPORT RD",
            "address_2": "STE 1",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355042517",
            "telephone_number": "205-221-6700",
            "fax_number": "205-221-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAFFORD DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "STAFFORD",
        "authorized_official_first_name": "MYRA",
        "authorized_official_middle_name": "MONTGOMERY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-221-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.