Active NPI
Dental Associates of Madison, LLC
- Dentist
- Madison, AL
National Provider Identifier
1952543779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4231
- Legal business name
- DENTAL ASSOCIATES OF MADISON, LLC
- Practice address
- 4072 Sullivan St
Suite a
Madison, AL 35758-3152 - Phone
- (256) 772-9988
- Fax
- (256) 772-9991
- NPI assigned
- Mar 25, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Terri Wrenn
- Title
- Administrative Assistant
- Phone
- (256) 772-9988
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4231 | AL | Primary |
Addresses
Primary practice location
4072 Sullivan St
Suite a
Madison, AL 35758-3152
Mailing address
4072 Sullivan St
Suite a
Madison, AL 35758-3152
Phone (256) 772-9988
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51091741 | Other | AL | BCBS AL |
| 000091741 | Medicaid | AL |
National Provider Directory
National Provider DirectoryLocations
4072 Sullivan St
Ste A
Madison, AL 35758
Phone (256) 772-9988
Practitioners & affiliated clinicians
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.
-
- Dentist
- Bentonville, AR
- NPI 1164090346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237939200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1237939200000",
"number": "1952543779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4072 SULLIVAN ST",
"address_2": "SUITE A",
"city": "MADISON",
"state": "AL",
"postal_code": "357583152",
"telephone_number": "256-772-9988",
"fax_number": "256-772-9991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4072 SULLIVAN ST",
"address_2": "SUITE A",
"city": "MADISON",
"state": "AL",
"postal_code": "357583152",
"telephone_number": "256-772-9988",
"fax_number": "256-772-9991"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DENTAL ASSOCIATES OF MADISON, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-03-25",
"last_updated": "2009-03-25",
"status": "A",
"authorized_official_last_name": "WRENN",
"authorized_official_first_name": "TERRI",
"authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
"authorized_official_telephone_number": "256-772-9988",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "AL",
"license": "4231",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS AL",
"identifier": "51091741",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000091741",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, AL
- Emily Defourneaux, CRNP
- Deirdre Z Joiner Nichols MD LLC
- Stephanie Diane Dempsey, BCBA
- Denise Draa Counseling Services, LLC (Living Life Counseling Center)
- Kevin Scott Denny, M.D.
- Hannah Denton, NP
- Misty McCants Deramus, LCSW
- Diagnostic Health MRI of Gadsden, LLC (Outpatient Diagnostic Center of Madison)
- Dezerei G Diaz, LMSW
- Rebecca Rae Dickerson, CRNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.