NPIMap

Organization Active NPI

Mobile Bay Dental LLC

  • Dentist
  • Mobile, AL
National Provider Identifier
1922193002
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5226 Issued in AL
Legal business name
MOBILE BAY DENTAL LLC
Practice address
301 Saint Joseph St
Mobile, AL 36602-4037
Phone
(251) 433-7717
Fax
(251) 433-9384
NPI assigned
Oct 4, 2006
Last updated
Aug 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Authorized official

Name
Dr. Lance Christopher Hankinson, D.M.D
Title
Dentist
Phone
(251) 433-7717

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5226 AL Primary
Optometrist 152W00000X S-779-TA-178 AL

Addresses

Primary practice location

301 Saint Joseph St
Mobile, AL 36602-4037

Mailing address

301 Saint Joseph St
Mobile, AL 36602-4037
Phone (251) 433-7717

Other identifiers 2

IdentifierTypeStateIssuer
529912860MedicaidAL
14048OtherALBCBS OF ALABAMA

National Provider Directory

National Provider Directory
Tax ID family
Mobile Bay Dental LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1922193002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SAINT JOSEPH ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366024037",
            "telephone_number": "251-433-7717",
            "fax_number": "251-433-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAINT JOSEPH ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366024037",
            "telephone_number": "251-433-7717",
            "fax_number": "251-433-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE BAY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "HANKINSON",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "251-433-7717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5226",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-779-TA-178",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529912860",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "14048",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.