REGIONAL DENTAL CENTER (NPI# 1154748218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154748218 |
| Entity Type | Organization |
| Organization Name | REGIONAL DENTAL CENTER |
| Practice Address |
505 Pelham Rd S Jacksonville AL 36265-2775 |
| Practice Telephone | 2564354464 |
| Practice Fax Number | 2564352079 |
| Mailing Telephone | 2564354464 |
| Mailing Fax Number | 2564352079 |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |
| Authorized Official Name | DR. WILLIAM BRUCE YOUNG (OWNER) |
| Authorized Official Telephone | 2564354464 |
| Authorized Official Credential | D.O |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
3308 | AL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | DELTA | 3308 | 01 |
| AL | BLUE CROSS BLUE SHEILD OF ALABAMA | 51097747 | 01 |
| AL | UNITED CONCORDIA | 793127 | 01 |
| AL | 000097747 | 05 |
| Street Address |
505 PELHAM RD S |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265-2775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780607010 | William Bruce Young | Dentist | 505 Pelham Rd S, Jacksonville, AL 36265-2775 | 2006-07-26 |
| 1114234010 | William Bruce Young Dmd | Dentist | 505 Pelham Rd S, Ste A, Jacksonville, AL 36265-2775 | 2010-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962018424 | Sydney Fowler | Dentist | 12276 San Jose Blvd Ste 314, Jacksonville, FL 32223-8632 | 2020-09-21 |
| 1871106260 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 4445 Town Center Pkwy, Jacksonville, FL 32246-8565 | 2020-08-26 |
| 1831710771 | Mark William Russell | Dentist | 461 Western Blvd Ste 104, Jacksonville, NC 28546-7637 | 2020-05-01 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1659923118 | San Jose Aspen Pllc | Dentist | 10502 San Jose Blvd Ste B, Jacksonville, FL 32257-6209 | 2019-07-15 |
| 1326603176 | Evens Family Dental | Dentist | 13107 Atlantic Blvd, Jacksonville, FL 32225-7127 | 2019-05-07 |
| 1487123006 | Susan Prater Kudlats, D.m.d, P.a. | Dentist | 12620 Beach Blvd Ste 18, Jacksonville, FL 32246-7130 | 2018-11-14 |
| 1043792534 | Atlantic Dentistry Pa | Dentist | 13474 Atlantic Blvd Ste 109, Jacksonville, FL 32225-0100 | 2018-08-31 |
| 1447738620 | Argyle Dental Pllc | Dentist | 6001 Argyle Forest Blvd Ste 4, Jacksonville, FL 32244-6127 | 2018-07-31 |
| 1427534445 | Sandeep Chunduru | Dentist | 571 Yopp Rd Ste 308, Jacksonville, NC 28540-3683 | 2018-07-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.