J. Shane Roberts Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4013 Issued in AL

Legal business name

J. SHANE ROBERTS FAMILY DENTISTRY

Practice address

904 4TH St
Pleasant Grove, AL 35127-1059

Phone

(205) 744-4258

Fax

(205) 744-4255

NPI assigned

Sep 7, 2017

Last updated

Sep 7, 2017By 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. Jerry Shane Roberts

Title

Dentist

Phone

(205) 744-4258

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• J Shane Roberts, DMD

  • General Practice Dentistry
  • Pleasant Grove, AL
  • NPI 1710195466
  NPD (past)

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504742400000",
    "number": "1861910036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 445",
            "city": "PLEASANT GROVE",
            "state": "AL",
            "postal_code": "351270445",
            "telephone_number": "205-744-4258",
            "fax_number": "205-744-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 4TH ST",
            "city": "PLEASANT GROVE",
            "state": "AL",
            "postal_code": "351271059",
            "telephone_number": "205-744-4258",
            "fax_number": "205-744-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. SHANE ROBERTS FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-09-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "205-744-4258",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "4013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrinthia Machell Duff, REGISTERED NURSE
• Monica T Fields
• Fountain of Care Solutions in Home and Healthcare LLC
• Terrell Gardner
• Joi Iman Gresham, LICSW
• Ja'Karia M Johnson
• Dorothy Lavender
• Legacy Health and Rehabilitation of Pleasant Grove, LLC
• London's Touch (Little Einsteins)
• Judy Mallah

• Dental Clinic/Center in Pleasant Grove, AL
• Providers in Pleasant Grove, 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 7, 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.