Thomas Brent Church, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

6294 Issued in AL

Practice address

5528 1St Ave N
Birmingham, AL 35212-2445

Phone

(205) 592-2255

NPI assigned

Jun 11, 2016

Last updated

Jun 11, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Drtbc, LLC

  dba Church Family Dental

  • Dental Clinic/Center
  • Hueytown, AL
  • NPI 1255053146
  NPD Authorized official
• Proact Dental, Inc.

  dba Smiles for Keeps

  • General Practice Dentistry
  • Birmingham, AL
  • NPI 1497837553
  NPD (past)

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

{
    "created_epoch": "1465603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465603200000",
    "number": "1659720415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 9TH TER",
            "city": "PLEASANT GROVE",
            "state": "AL",
            "postal_code": "351272209",
            "telephone_number": "205-478-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5528 1ST AVE N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352122445",
            "telephone_number": "205-592-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "THOMAS",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-11",
        "last_updated": "2016-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara K Chung I, MD
• Edward Hun Chung, DO
• Sua Hope Chung
• Robyn Chunn
• Casey Church, OTR/L
• Alice Haygood Churnock, M.A., LPC
• Leanne Cianfrini, PH.D.
• James Cilimberg, P.A.
• Lauren Hammond Cimino
• Citizen Express Pharmacy

• Dentist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.