Complete Dental Center Huntsville

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5290 Issued in AL

Legal business name

COMPLETE DENTAL CENTER HUNTSVILLE

Practice address

7540 Memorial Pkwy SW
Suite R
Huntsville, AL 35802-2265

Phone

(256) 258-0777

NPI assigned

Jan 12, 2010

Last updated

Jan 12, 2010By 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. Shelly M Johnson

Title

Manager

Phone

(256) 774-7228

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1619207719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W DUBLIN DR",
            "address_2": "SUITE 202",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357583155",
            "telephone_number": "256-774-7228",
            "fax_number": "256-774-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 MEMORIAL PKWY SW",
            "address_2": "SUITE R",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358022265",
            "telephone_number": "256-258-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE DENTAL CENTER HUNTSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "256-774-7228",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Huntsville, AL
• Providers in Huntsville, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.