Jasper Pediatric Dentistry, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

4967 Issued in AL

Legal business name

JASPER PEDIATRIC DENTISTRY, LLC

Practice address

4330 Highway 78 E
Suite 121
Jasper, AL 35501-8905

Phone

(205) 384-9104

Fax

(205) 384-9102

NPI assigned

Mar 13, 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

Dr. Katrina Carol White, DMDNPI 1164555967

Title

Owner

Phone

(205) 384-9104

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Katrina Carol White, DMD

  • Pediatric Dentistry
  • Jasper, AL
  • NPI 1164555967
  NPD (past) Authorized official

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649303355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 HIGHWAY 78 E",
            "address_2": "SUITE 121",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018905",
            "telephone_number": "205-384-9104",
            "fax_number": "205-384-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 HIGHWAY 78 E",
            "address_2": "SUITE 121",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018905",
            "telephone_number": "205-384-9104",
            "fax_number": "205-384-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-384-9104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "4967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51506630",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasper Family Practice Center PC
• Jasper Gastroenterology Inc.
• Jasper General Surgery
• Jasper Hearing Center, LLC
• Jasper Medical Supply, Inc.
• Jasper Podiatry Center, P.C.
• Jasper Senior Living LLC (The Terrace Senior Living Community)
• Jasper Urgent Care
• Miali Praytor Jennings, CRNP
• Jernigan Healthcare, Inc.

• Pediatric Dentistry in Jasper, AL
• Providers in Jasper, 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.