Timberland Dental, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5114 Issued in AL

Legal business name

TIMBERLAND DENTAL, PC

Practice address

301 E 1St St
Bay Minette, AL 36507-4029

Phone

(251) 580-0979

Fax

(251) 580-0971

NPI assigned

Sep 29, 2010

Last updated

Sep 29, 2010By 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. Harry Huger Houston III, DDS

Title

President/Owner

Phone

(251) 580-0979

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1801105556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E 1ST ST",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074029",
            "telephone_number": "251-580-0979",
            "fax_number": "251-580-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 1ST ST",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074029",
            "telephone_number": "251-580-0979",
            "fax_number": "251-580-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBERLAND DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "HUGER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "251-580-0979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "5114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "515-38527",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009931835",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Bay Minette, AL
• Providers in Bay Minette, 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 Sep 29, 2010; 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.