NPIMap

Organization Active NPI

Franklin Primary Health Center, Inc.

Doing business as Brewton Family Dental Center

  • General Practice Dentistry
  • Brewton, AL
National Provider Identifier
1700206703
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FRANKLIN PRIMARY HEALTH CENTER, INC.
Doing business as
Brewton Family Dental Center
Practice address
1115 Azalea PL
Brewton, AL 36426-1318
Phone
(251) 867-8020
Fax
(251) 867-8079
NPI assigned
Apr 17, 2014
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANKLIN PRIMARY HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Mr. Charles N/a White
Title
Ceo
Phone
(251) 432-4117

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU Primary
Pediatric Dentistry 1223P0221X NU
Periodontics 1223P0300X NU
Dental Hygienist 124Q00000X NU
Dental Assistant 126800000X NU

Addresses

Primary practice location

1115 Azalea PL
Brewton, AL 36426-1318

Mailing address

1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341
Phone (251) 432-4117

Other names 1

  • Brewton Family Dental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040618000827 AL Part B Supplier - Clinic/Group Practice 1658356308 Receives reassigned benefits from 126 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mobile, AL; Prichard, AL; Uriah, AL; Frisco City, AL; Loxley, AL; Brewton, AL; Evergreen, AL; Foley, AL…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700206703. Details of each certification follow.

  • CCN 011057 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 011057

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BREWTON FAMILY DENTAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 26, 2019
Last certification
Aug 26, 2019
Ownership / control type
For profit – partnership
Facility address
1115 Azalea PL
Brewton, AL 36426

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory
Part of
Franklin Memorial Prima

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1700206703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 DR MARTIN L KING JR AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035341",
            "telephone_number": "251-432-4117",
            "fax_number": "251-436-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 AZALEA PL",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261318",
            "telephone_number": "251-867-8020",
            "fax_number": "251-867-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN PRIMARY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANKLIN PRIMARY HEALTH CENTER, INC",
        "enumeration_date": "2014-04-17",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "N/A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-432-4117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brewton Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brewton Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brewton, AL

Sources for this page

Verify at the official NPI Registry.