Active NPI
Evergreen Dental Center
- Dentist
- Evergreen, AL
National Provider Identifier
1467526038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD5370C
- Legal business name
- EVERGREEN DENTAL CENTER
- Practice address
- 100 Edwina Street
Evergreen, AL 36401 - Phone
- (251) 578-3331
- Fax
- (251) 578-2006
- NPI assigned
- Nov 17, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert P Louis, DDS
- Title
- Executive Director
- Phone
- (251) 578-3331
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD5370C | AL | Primary |
Addresses
Primary practice location
100 Edwina Street
Evergreen, AL 36401
Mailing address
PO Box 266
Evergreen, AL 36401
Phone (251) 578-3331
National Provider Directory
National Provider Directory- Tax ID family
- Evergreen Dental Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1467526038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 266",
"city": "EVERGREEN",
"state": "AL",
"postal_code": "36401",
"telephone_number": "251-578-3331",
"fax_number": "251-578-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EDWINA STREET",
"city": "EVERGREEN",
"state": "AL",
"postal_code": "36401",
"telephone_number": "251-578-3331",
"fax_number": "251-578-2006"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERGREEN DENTAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-17",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "LOUIS",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "251-578-3331",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "DD5370C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen, AL
- Dura-Med Southeast Inc
- Dura-Med Southeast Inc (Evergreen City Drugs)
- Kelsi Dykes, CLC
- Lakoya Edmonds, M.S.
- Encore Rehabilitation, Inc. (Encore Rehab of Evergreen)
- Evergreen Discount Pharmacy, Inc
- Evergreen Medical Center Hospice, LLC
- Evergreen Medical Center LLC (Evergreen Primary Care)
- Evergreen Medical Center LLC (Evergreen Primary Care)
- Evergreen Medical Center LLC (Evergreen Home Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.