NPIMap

Organization Active NPI

Alabama Dental Professionals, P.C.

Doing business as Plaza Boulevard Dental

  • General Practice Dentistry
  • Madison, AL
National Provider Identifier
1851498059
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ALABAMA DENTAL PROFESSIONALS, P.C.
Doing business as
Plaza Boulevard Dental
Rousseau Family Dentistry
Practice address
136 Plaza Blvd
Suite a
Madison, AL 35758-1160
Phone
(256) 464-3556
Fax
(256) 464-3553
NPI assigned
Sep 20, 2006
Last updated
Aug 1, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ALABAMA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Authorized official

Name
Heather Pruemer
Title
Credentialing Team Lead
Phone
(217) 540-8434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

136 Plaza Blvd
Suite a
Madison, AL 35758-1160

Mailing address

136 Plaza Blvd
Suite a
Madison, AL 35758-1160
Phone (256) 464-3556

Other names 2

  • Plaza Boulevard Dental Doing business as
  • Rousseau Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alabama Dental Professionals PC21 organizations share this tax ID, including this one
Part of
Alabama Dental Professionals PC

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

136 Plaza Blvd
Ste A
Madison, AL 35758
Phone (256) 464-3556

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501545600000",
    "number": "1851498059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 PLAZA BLVD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581160",
            "telephone_number": "256-464-3556",
            "fax_number": "256-464-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 PLAZA BLVD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581160",
            "telephone_number": "256-464-3556",
            "fax_number": "256-464-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALABAMA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALABAMA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-08-01",
        "status": "A",
        "authorized_official_last_name": "PRUEMER",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8434"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plaza Boulevard Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rousseau Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; 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.