Mountain Smiles - Prattville PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MOUNTAIN SMILES - PRATTVILLE PLLC

Practice address

711 Kornegay Dr Ste a
Prattville, AL 36066-7715

Phone

(334) 285-7111

NPI assigned

Mar 25, 2026

Last updated

Mar 25, 2026By 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

Angel Gimenez

Title

Credentialing Senior Manager

Phone

(719) 300-5933

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Kim Pierson Kornegay, DMD

  • General Practice Dentistry
  • Prattville, AL
  • NPI 1417066093
  NPD (past)
• Mark B. Tickle, DMD

  • Dentist
  • Prattville, AL
  • NPI 1477886026
  NPD (past)

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

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1497693709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KORNEGAY DR STE A",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667715",
            "telephone_number": "334-285-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 KORNEGAY DR STE A",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667715",
            "telephone_number": "334-285-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN SMILES - PRATTVILLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "GIMENEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "CREDENTIALING SENIOR MANAGER",
        "authorized_official_telephone_number": "719-300-5933"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mora Surgical Clinic, P.C.
• Parham Mora, M.D.
• David L Morgan
• Marianne Morgan, MCD
• Melanie A Morrow, LCSW, PIP
• Edwin R. Mullins, DMD
• Thomas Franklin Munsey, CRNA
• Azalea Murgo
• Jeana Ann Murphy, CRNP
• Evan Labarge Murry

• Dental Clinic/Center in Prattville, AL
• Providers in Prattville, AL by specialty
• Dental Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.