NPIMap

Organization Active NPI

Pediatric Dental Associates, LLC

  • Pediatric Dentistry
  • Pell City, AL
National Provider Identifier
1700056124
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
LNO5181 Issued in AL
Legal business name
PEDIATRIC DENTAL ASSOCIATES, LLC
Practice address
2806 Dr John Haynes Dr Ste B
Pell City, AL 35125-1485
Phone
(205) 338-4227
Fax
(205) 338-4204
NPI assigned
Mar 3, 2008
Last updated
Mar 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Dr. Richard B Chambliss Jr., DMD
Title
President
Phone
(205) 338-4227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X LNO5181 AL Primary

Addresses

Primary practice location

2806 Dr John Haynes Dr Ste B
Pell City, AL 35125-1485

Mailing address

2806 Dr John Haynes Dr Ste B
Pell City, AL 35125-1485
Phone (205) 338-4227

National Provider Directory

National Provider Directory

Locations

2806 Dr John Haynes Dr
Ste B
Pell City, AL 35125
Phone (205) 338-4227

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1700056124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 DR JOHN HAYNES DR STE B",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351251485",
            "telephone_number": "205-338-4227",
            "fax_number": "205-338-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 DR JOHN HAYNES DR STE B",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351251485",
            "telephone_number": "205-338-4227",
            "fax_number": "205-338-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "CHAMBLISS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-338-4227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "LNO5181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pell City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.