NPIMap

Organization Active NPI

MRM, LLC

  • Dentist
  • Tuscaloosa, AL
National Provider Identifier
1558468108
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MRM, LLC
Doing business as
Dental Works
Practice address
1402 Veterans Memorial Pkwy
Suite B
Tuscaloosa, AL 35404-4790
Phone
(205) 556-6511
Fax
(205) 556-6571
NPI assigned
Sep 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Authorized official

Name
Dr. Matthew Ryan McCracken, D.M.D.NPI 1316032667
Title
Dentist/Manager
Phone
(205) 556-6511

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X

Addresses

Primary practice location

1402 Veterans Memorial Pkwy
Suite B
Tuscaloosa, AL 35404-4790

Mailing address

1402 Veterans Memorial Pkwy
Suite B
Tuscaloosa, AL 35404-4790
Phone (205) 556-6511

Other names 1

  • Dental Works Doing business as

National Provider Directory

National Provider Directory

Locations

1402 Veterans Memorial Pkwy
Ste B
Tuscaloosa, AL 35404
Phone (205) 556-6511

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1558468108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 VETERANS MEMORIAL PKWY",
            "address_2": "SUITE B",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354044790",
            "telephone_number": "205-556-6511",
            "fax_number": "205-556-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 VETERANS MEMORIAL PKWY",
            "address_2": "SUITE B",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354044790",
            "telephone_number": "205-556-6511",
            "fax_number": "205-556-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "MCCRACKEN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "DENTIST/MANAGER",
        "authorized_official_telephone_number": "205-556-6511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Works",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.