Complete Dental of Mobile

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5565 Issued in AL

Legal business name

COMPLETE DENTAL OF MOBILE

Practice address

5651 Three Notch Rd
Mobile, AL 36619-1617

Phone

(251) 661-1003

Fax

(251) 661-2709

NPI assigned

Sep 3, 2011

Last updated

Dec 6, 2011By 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

Dr. Shaun Gary Small, D.M.D., M.P.H.NPI 1144482787

Title

Owner

Phone

(251) 661-1003

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Shaun G Small, D.M.D., M.P.H.

  • Dentist
  • Mobile, AL
  • NPI 1144482787
  NPD (past) Authorized official
• Ronald Gordon Young, DMD

  • Dentist
  • Mobile, AL
  • NPI 1124758024
  NPD (past)

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

{
    "created_epoch": "1315008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1790066728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 THREE NOTCH RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366191617",
            "telephone_number": "251-661-1003",
            "fax_number": "251-661-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 THREE NOTCH RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366191617",
            "telephone_number": "251-661-1003",
            "fax_number": "251-661-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE DENTAL OF MOBILE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-03",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-661-1003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D., M.P.H."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "5565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Mobile, AL
• Providers in Mobile, 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 Dec 6, 2011; 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.