NPIMap

Organization Active NPI

Joseph Ronderos DMD PC

Doing business as Springville Family Dental Center

  • General Practice Dentistry
  • Springville, AL
National Provider Identifier
1487999769
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4254 Issued in AL
Legal business name
JOSEPH RONDEROS DMD PC
Doing business as
Springville Family Dental Center
Practice address
420 Walker Dr
Springville, AL 35146-3250
Phone
(205) 467-6147
Fax
(205) 467-2933
NPI assigned
Nov 28, 2012
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Dr. Joseph Vincent Ronderos Sr., D.M.D.NPI 1902995095
Title
President
Phone
(205) 467-6147

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 4254 AL Primary

Addresses

Primary practice location

420 Walker Dr
Springville, AL 35146-3250

Mailing address

420 Walker Dr
PO Box 706
Springville, AL 35146-3250
Phone (205) 467-6147

Other identifiers 1

IdentifierTypeStateIssuer
008905230MedicaidAL

Other names 1

  • Springville Family Dental Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1487999769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WALKER DR",
            "address_2": "PO BOX 706",
            "city": "SPRINGVILLE",
            "state": "AL",
            "postal_code": "351463250",
            "telephone_number": "205-467-6147",
            "fax_number": "205-467-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WALKER DR",
            "city": "SPRINGVILLE",
            "state": "AL",
            "postal_code": "351463250",
            "telephone_number": "205-467-6147",
            "fax_number": "205-467-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH RONDEROS DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "RONDEROS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-467-6147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008905230",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springville Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.