Coastal Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

COASTAL DENTAL LLC

Doing business as

Coastal Family Dentistry

Practice address

208 W 19TH Ave
Gulf Shores, AL 36542-3041

Phone

(251) 968-8789

Fax

(251) 968-6520

NPI assigned

Mar 12, 2025

Last updated

Mar 12, 2025By 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

Dr. Austin Matthew Jordan, DMDNPI 1477282994

Title

Dentist/Owner

Phone

(251) 362-4490

Specialties & licenses 1

Addresses

Other names 1

• Coastal Family Dentistry 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, and the practitioner matching its NPPES authorized official.

• Austin Jordan

  • Dentist
  • Selma, AL
  • NPI 1477282994
  NPD Authorized official

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

{
    "created_epoch": "1741737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1518766401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W 19TH AVE",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365423041",
            "telephone_number": "251-968-8789",
            "fax_number": "251-968-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W 19TH AVE",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365423041",
            "telephone_number": "251-968-8789",
            "fax_number": "251-968-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "251-362-4490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tamara Tidwell Cerniglia, FNP
• Chiropractic Care, Inc.
• Chiropractic Connection
• City of Gulf Shores Inc (Gulf Shores Department of Fire & Emergency Services)
• Clearwater Counseling, LLC
• Coastal Wellness LLC
• Madison Eleanor Cookston, OTD,OTR/L
• Lyle Cooper, DC
• Lyle Keith Cooper II, LPC
• Summer Costigan

• Dental Clinic/Center in Gulf Shores, AL
• Providers in Gulf Shores, 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 12, 2025; 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.