Pda Ortho Cullman LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

PDA ORTHO CULLMAN LLC

Practice address

1907 Main Ave SW Ste a
Cullman, AL 35055-5218

Phone

(256) 279-9852

NPI assigned

Jul 22, 2021

Organization subpart

No

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

Authorized official

Name

Mallory Samuelson

Title

Operations Manager

Phone

(615) 631-9226

Specialties & licenses 1

Addresses

Other names 1

• Cullman Orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danielle Gilbert, D.M.D

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Birmingham, AL
  • NPI 1063874931
  NPD

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1467025866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5564 GROVE BLVD STE A",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352264601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 MAIN AVE SW STE A",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350555218",
            "telephone_number": "256-279-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDA ORTHO CULLMAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "SAMUELSON",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "615-631-9226"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cullman Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cullman Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nikki Patun
• Paul D. Bussman, D.M.D. P.C.
• Paul D. Freeman DMD
• Paul Dudley Freeman Estate Beth Mullins Freeman Adm
• Sabrina Gilley Payne, RN
• Pediatric Dental Associates of Cullman, LLC
• Deborah A Peinhardt, CRNP
• William F Peinhardt, MD
• Pentastar, LLC
• People'S Choice Pharmacy

• Orthodontics and Dentofacial Orthopedics Dentistry in Cullman, AL
• Providers in Cullman, AL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.