NPIMap

Organization Active NPI

Dandridge Dental PC

  • Exclusive Provider Organization
  • Dothan, AL
National Provider Identifier
1962793893
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
5492 Issued in AL
Legal business name
DANDRIDGE DENTAL PC
Doing business as
Dandridge Dental Family Dentistry
Practice address
1435 Ross Clark Cir
Suite a-1
Dothan, AL 36301-4744
Phone
(334) 699-2220
Fax
(334) 699-2223
NPI assigned
Apr 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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

Authorized official

Name
Dr. Michelle Nicole Dandridge, DMD
Title
Owner
Phone
(334) 699-2220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 5492 AL Primary

Addresses

Primary practice location

1435 Ross Clark Cir
Suite a-1
Dothan, AL 36301-4744

Mailing address

1435 Ross Clark Cir
Suite a-1
Dothan, AL 36301-4744
Phone (334) 699-2220

Other names 1

  • Dandridge Dental Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1435 Ross Clark Cir
Ste A1
Dothan, AL 36301
Phone (334) 699-2220

Practitioners & affiliated clinicians

Practitioners 4

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": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1962793893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 ROSS CLARK CIR",
            "address_2": "SUITE A-1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014744",
            "telephone_number": "334-699-2220",
            "fax_number": "334-699-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 ROSS CLARK CIR",
            "address_2": "SUITE A-1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014744",
            "telephone_number": "334-699-2220",
            "fax_number": "334-699-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANDRIDGE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "DANDRIDGE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-699-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "AL",
            "license": "5492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dandridge Dental Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.