Pediatric Dentistry Associates, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3156 Issued in AL

Legal business name

PEDIATRIC DENTISTRY ASSOCIATES, PC

Practice address

121 N 20TH St
Suite 20-C
Opelika, AL 36801-5449

Phone

(334) 745-6443

Fax

(334) 745-3444

NPI assigned

Mar 21, 2007

Last updated

Aug 22, 2020By 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

Mrs. Elizabeth K Carroll

Title

Corporate Secretary

Phone

(334) 745-6443

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598881716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N 20TH ST",
            "address_2": "SUITE 20-C",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015449",
            "telephone_number": "334-745-6443",
            "fax_number": "334-745-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N 20TH ST",
            "address_2": "SUITE 20-C",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015449",
            "telephone_number": "334-745-6443",
            "fax_number": "334-745-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "334-745-6443",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "3156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlena Grace Payne, LAT, ATC
• Bradley Wilson Peden, M.D.
• Jessica Leigh Pedersen, ARNP
• Pediatric Associates of Auburn
• Pediatric Clinic LLC
• Perception Therapy LLC
• Melissa Jones Perry
• Sandra Edwards Perry
• Elisa Miller Pesto, MS, OTR/L
• Bryan Thomas Peters

• Pediatric Dentistry in Opelika, AL
• Providers in Opelika, AL by specialty
• Pediatric Dentistry in Alabama

• 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.

Verify at the official NPI Registry.