NPIMap

Organization Active NPI

Mark Tickle Family and Implant Dentistry

  • General Practice Dentistry
  • Tuscaloosa, AL
National Provider Identifier
1851751986
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5706 Issued in AL
Legal business name
MARK TICKLE FAMILY AND IMPLANT DENTISTRY
Practice address
601 Hargrove Rd E
Suite B
Tuscaloosa, AL 35401-3792
Phone
(205) 758-0200
NPI assigned
Mar 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Authorized official

Name
Dr. Mark Tickle, DMD
Title
Owner
Phone
(205) 758-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5706 AL Primary

Addresses

Primary practice location

601 Hargrove Rd E
Suite B
Tuscaloosa, AL 35401-3792

Mailing address

601 Hargrove Rd E
Suite B
Tuscaloosa, AL 35401-3792
Phone (205) 758-0200

National Provider Directory

National Provider Directory

Locations

601 Hargrove Rd E
Ste B
Tuscaloosa, AL 35401
Phone (205) 758-0200

Practitioners & affiliated clinicians

Practitioners 1

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": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1851751986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HARGROVE RD E",
            "address_2": "SUITE B",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354013792",
            "telephone_number": "205-758-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HARGROVE RD E",
            "address_2": "SUITE B",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354013792",
            "telephone_number": "205-758-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TICKLE FAMILY AND IMPLANT DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "TICKLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-758-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 2, 2016; 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.