NPIMap

Organization Active NPI

Pediatric and Adolescent Dentistry, LLC

  • Pediatric Dentistry
  • Birmingham, AL
National Provider Identifier
1851585079
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5122 Issued in AL
Legal business name
PEDIATRIC AND ADOLESCENT DENTISTRY, LLC
Practice address
5346 Stadium Trace Pkwy
Suite 108
Birmingham, AL 35244-4582
Phone
(205) 982-0112
Fax
(205) 982-0737
NPI assigned
Aug 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Authorized official

Name
Dr. William Clark Thomas, DMDNPI 1871703835
Title
President
Phone
(205) 982-0112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 5122 AL Primary

Addresses

Primary practice location

5346 Stadium Trace Pkwy
Suite 108
Birmingham, AL 35244-4582

Mailing address

5346 Stadium Trace Pkwy
Suite 108
Birmingham, AL 35244-4582
Phone (205) 982-0112

Other identifiers 1

IdentifierTypeStateIssuer
51540792OtherALBC/BS

National Provider Directory

National Provider Directory

Locations

1015 Brocks Gap Pkwy
Hoover, AL 35244
Phone (205) 982-0112

5346 Stadium Trace Pkwy
Ste 108
Hoover, AL 35244
Phone (205) 982-0112

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1851585079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5346 STADIUM TRACE PKWY",
            "address_2": "SUITE 108",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352444582",
            "telephone_number": "205-982-0112",
            "fax_number": "205-982-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5346 STADIUM TRACE PKWY",
            "address_2": "SUITE 108",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352444582",
            "telephone_number": "205-982-0112",
            "fax_number": "205-982-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADOLESCENT DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-982-0112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "5122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "51540792",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.