NPIMap

Organization Active NPI

LD-Tuscaloosa, LLC

Doing business as Forest Lake Dental

  • Dental Clinic/Center
  • Tuscaloosa, AL
National Provider Identifier
1841907466
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LD-TUSCALOOSA, LLC
Doing business as
Forest Lake Dental
Practice address
1434 2ND CT E
Tuscaloosa, AL 35401-3200
Phone
(205) 752-5400
Fax
(662) 586-2995
NPI assigned
Nov 2, 2022
Last updated
Jul 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Authorized official

Name
Lauren S Daigneault, BA, MA
Title
Admin Director
Phone
(256) 783-9468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1434 2ND CT E
Tuscaloosa, AL 35401-3200

Mailing address

1434 2ND CT E
Tuscaloosa, AL 35401-3200
Phone (205) 752-5400

Other names 3

  • Forest Lake Dental Doing business as
  • New Image Family Dentistry, LLC Former legal business name
  • Rodney L. Goins, DMD, P.C. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1841907466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 2ND CT E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354013200",
            "telephone_number": "205-752-5400",
            "fax_number": "205-752-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 2ND CT E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354013200",
            "telephone_number": "205-752-5400",
            "fax_number": "662-586-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LD-TUSCALOOSA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "DAIGNEAULT",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMIN DIRECTOR",
        "authorized_official_telephone_number": "256-783-9468",
        "authorized_official_credential": "BA, MA"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Lake Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Image Family Dentistry, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Rodney L. Goins, DMD, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.