Satsuma Family Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SATSUMA FAMILY DENTAL PC

Practice address

5651 Highway 43
Satsuma, AL 36572-2115

Phone

(251) 679-9428

NPI assigned

Nov 21, 2019

Last updated

Jul 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diana TedderNPI 1801966494

Title

Owner

Phone

(251) 679-9428

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

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.

• Diana Sterling Tedder, DMD

  • General Practice Dentistry
  • Satsuma, AL
  • NPI 1801966494
  NPD Authorized official

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1730725045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 HIGHWAY 43",
            "city": "SATSUMA",
            "state": "AL",
            "postal_code": "365722115",
            "telephone_number": "251-679-9428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 HIGHWAY 43",
            "city": "SATSUMA",
            "state": "AL",
            "postal_code": "365722115",
            "telephone_number": "251-679-9428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATSUMA FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "TEDDER",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-679-9428"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnolia Medical Supply LLC
• Caye Margaret McConaghy, RPH, PHARMD
• Latoria Rivers McVay, BSN, RNC - NIC
• MK Non Emergency Medical Transport LLC
• Wilbur Embree Price, R.PH
• Jessica Leigh Scott, PHT
• Sandra Grace Scott, PHT
• Diana Sterling Tedder, DMD
• Jillian Blair Thomas, PHARM.D.
• Wendy Michelle Turner

• Dental Clinic/Center in Satsuma, AL
• Providers in Satsuma, AL by specialty
• Dental Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.