East Alabama Dental Group, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0005367 Issued in AL

Legal business name

EAST ALABAMA DENTAL GROUP, LLC

Practice address

1945 1St Ave
Opelika, AL 36801-5403

Phone

(334) 749-5014

Fax

(334) 749-9823

NPI assigned

Feb 18, 2010

Organization subpart

No

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

Authorized official

Name

Keith Allan ThompsonNPI 1073621538

Title

Owner

Phone

(334) 749-5014

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Keith Allan Thompson, DMD

  • General Practice Dentistry
  • Opelika, AL
  • NPI 1073621538
  NPD Authorized official

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1891017836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 1ST AVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015403",
            "telephone_number": "334-749-5014",
            "fax_number": "334-749-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 1ST AVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015403",
            "telephone_number": "334-749-5014",
            "fax_number": "334-749-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST ALABAMA DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-749-5014"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "0005367",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• East Alabama Endocrinology, P.C.
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• East Alabama Health Services LLC

• General Practice Dentistry in Opelika, AL
• Providers in Opelika, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.