Bennett Pediatric Dentistry, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BENNETT PEDIATRIC DENTISTRY, LLC

Practice address

960 Ross St
Heflin, AL 36264-1164

Phone

(256) 591-3443

NPI assigned

Aug 18, 2025

Last updated

Aug 18, 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

Mattie Bennett, DMDNPI 1700235934

Title

Owner

Phone

(256) 591-3443

Specialties & licenses 1

Addresses

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.

• Mattie Bennett, D.M.D.

  • Pediatric Dentistry
  • Heflin, AL
  • NPI 1700235934
  NPD Authorized official

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1609753136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 ALMON ST",
            "city": "HEFLIN",
            "state": "AL",
            "postal_code": "362641381",
            "telephone_number": "256-591-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 ROSS ST",
            "city": "HEFLIN",
            "state": "AL",
            "postal_code": "362641164",
            "telephone_number": "256-591-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETT PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "MATTIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-591-3443",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick Austin
• Sharon Beason, RN
• Mattie Bennett, D.M.D.
• Igor Bidikov, MD
• Deanna Marie Brown
• Calhoun-Cleburne Mental Health Board
• Cheaha Area Regional Emergency Specialist (C.a.R.E.S.)

• Dental Clinic/Center in Heflin, AL
• Providers in Heflin, 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 Aug 18, 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.