NPIMap

Organization Active NPI

Comfort Dental Care of Dothan LLC

  • Dentist
  • Dothan, AL
National Provider Identifier
1609139807
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3619 Issued in AL
Legal business name
COMFORT DENTAL CARE OF DOTHAN LLC
Practice address
4440 W Main St
Suite 2
Dothan, AL 36305-1178
Phone
(334) 792-3838
Fax
(334) 792-6910
NPI assigned
Jun 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Authorized official

Name
Dr. Franklin A Dentremont Jr., DMD
Title
Lead Dentist
Phone
(334) 792-3838

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 4021 AL
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 3619 AL Primary

Addresses

Primary practice location

4440 W Main St
Suite 2
Dothan, AL 36305-1178

Mailing address

4440 W Main St
Suite 2
Dothan, AL 36305-1178
Phone (334) 792-3838

Other identifiers 2

IdentifierTypeStateIssuer
51595942OtherALBLUE CROSS BLUE SHIELD
009967145MedicaidAL

Other names 1

  • Alabama Comfort Dental of Dothan Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alabama Comfort Dental of Dothan2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1609139807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W MAIN ST",
            "address_2": "SUITE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051178",
            "telephone_number": "334-792-3838",
            "fax_number": "334-792-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W MAIN ST",
            "address_2": "SUITE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051178",
            "telephone_number": "334-792-3838",
            "fax_number": "334-792-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT DENTAL CARE OF DOTHAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "DENTREMONT",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LEAD DENTIST",
        "authorized_official_telephone_number": "334-792-3838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AL",
            "license": "4021",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AL",
            "license": "3619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51595942",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009967145",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alabama Comfort Dental of Dothan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.