The Pediatric Dental Clinic

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

THE PEDIATRIC DENTAL CLINIC

Practice address

162 Ana Dr
Florence, AL 35630-1759

Phone

(256) 766-0270

NPI assigned

May 28, 2020

Organization subpart

No

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

Authorized official

Name

Penny Dison

Title

Receptionist

Phone

(256) 766-0270

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carson Myles Cruise, DMD

  • Pediatric Dentistry
  • Florence, AL
  • NPI 1104208651
  NPD
• David H Merritt, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Florence, AL
  • NPI 1700921533
  NPD (past)

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1679196307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 ANA DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 ANA DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301759",
            "telephone_number": "256-766-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "DISON",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "256-766-0270"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Health Care Authority of Lauderdale County and the City of Florenc
• The Health Care Authority of Lauderdale County and the City of Florenc
• The Health Care Authority of Lauderdale County and the City of Florenc
• The Healthcare Authority of Lauderdale County and the City of Florence
• The Lung Center, PC
• The Shoals Clinic PC
• The Uniform Shop, Inc.
• The West Clinic P.C.
• Therapy South - Florence LLC
• Therapy Village LLC

• All providers in Florence, AL
• Pediatric Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.