NPIMap

Organization Active NPI

Southern Dental Associates, P.a.

  • General Practice Dentistry
  • Pensacola, FL
National Provider Identifier
1700987732
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SOUTHERN DENTAL ASSOCIATES, P.A.
Practice address
151 W Airport Blvd
Pensacola, FL 32505
Phone
(850) 477-5252
Fax
(850) 477-5532
NPI assigned
Sep 25, 2006
Last updated
Jan 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Authorized official

Name
Mr. Andrew Ellison Trammell Jr., DMDNPI 1396846325
Title
Owner Dentist Secretary Officer
Phone
(850) 477-5252

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

151 W Airport Blvd
Pensacola, FL 32505

Mailing address

151 W Airport Blvd
Pensacola, FL 32505
Phone (850) 477-5252

National Provider Directory

National Provider Directory

Locations

151 W Airport Blvd
Pensacola, FL 32505
Phone (850) 477-5252

Practitioners & affiliated clinicians

Practitioners 5

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1700987732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32505",
            "telephone_number": "850-477-5252",
            "fax_number": "850-477-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32505",
            "telephone_number": "850-477-5252",
            "fax_number": "850-477-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "TRAMMELL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "ELLISON",
        "authorized_official_title_or_position": "OWNER DENTIST SECRETARY OFFICER",
        "authorized_official_telephone_number": "850-477-5252",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.