Organization Active NPI

South East Dentistry

Doing business as Ashville Dental Center

  • General Practice Dentistry
  • Ashville, AL
National Provider Identifier
1669666863
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AL5363 Issued in AL
Legal business name
SOUTH EAST DENTISTRY
Doing business as
Ashville Dental Center
Practice address
125 Medical Circle
Ashville, AL 35953
Phone
(205) 594-5171
Fax
(205) 594-7311
NPI assigned
Aug 30, 2007
Last updated
Aug 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Authorized official

Name
Ms. Kimberly R Gilley
Title
Office Manager
Phone
(205) 594-5171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X AL5363 AL Primary

Addresses

Primary practice location

125 Medical Circle
Ashville, AL 35953

Mailing address

PO Box 790
Ashville, AL 35953-0000
Phone (205) 594-5171

Other names 1

  • Ashville Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

125 Medical Cir
Ashville, AL 35953
Phone (205) 594-5171

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1669666863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "ASHVILLE",
            "state": "AL",
            "postal_code": "359530000",
            "telephone_number": "205-594-5171",
            "fax_number": "205-594-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MEDICAL CIRCLE",
            "city": "ASHVILLE",
            "state": "AL",
            "postal_code": "35953",
            "telephone_number": "205-594-5171",
            "fax_number": "205-594-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EAST DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "GILLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "205-594-5171",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL5363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashville Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.