SHOAL CREEK DENTAL (NPI# 1194216861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194216861 |
| Entity Type | Organization |
| Organization Name | SHOAL CREEK DENTAL |
| Practice Address |
1303 Highway 72 Killen AL 35645-9136 |
| Practice Telephone | 2567575314 |
| Mailing Telephone | 2567575314 |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |
| Authorized Official Name | BRUCE EVANS (OWNER) |
| Authorized Official Telephone | 2567668800 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
3415 | AL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 164755 | 05 |
| Street Address |
1303 HIGHWAY 72 |
| City | KILLEN |
| State | AL |
| Zip Code | 35645-9136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770030843 | Advantage Health Solutions,llc | Family Medicine | 6492 Hwy 72, Killen, AL 35645 | 2016-09-07 |
| 1871713032 | Obrien Orthopedic PC | Orthopaedic Surgery | 6490 Highway 72, Athens, AL 35645 | 2007-04-27 |
| 1376656793 | W Barry Wood | Pharmacist | 1621 Hwy 72, Killen, AL 35645 | 2006-08-17 |
| 1811975881 | Misty White Robertson | Nurse Practitioner | 351 Highway 64, Killen, AL 35645 | 2006-01-09 |
| 1467443424 | David Alan Hollis | Family Medicine | 148 J C Mauldin Highway, Killen, AL 35645 | 2005-10-31 |
| 1093717696 | Steve E Wampler | Emergency Medicine | 351 Hwy 64, Killen, AL 35645 | 2005-08-12 |
| 1942408877 | Meares Family Chiropractic, Inc | Chiropractor | 5750 Highway 72 East, Killen, AL 35645 | 2007-07-03 |
| 1639234982 | Greenhill Family Clinic, LLC | Clinic/Center | 351 Highway 64, Killen, AL 35645 | 2006-12-27 |
| 1841203155 | Elizabeth Nelson Plott | Pharmacist | 1161 Highway 72, Killen, AL 35645 | 2006-08-15 |
| 1295782696 | Alton Paul Reed | Emergency Medicine | 9173 Turtle Point Dr, Killen, AL 35645-2853 | 2006-05-30 |
| Find all providers in zip 35645 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205394319 | James Todd Chastain, Dmd, LLC | Clinic/Center | 150 J C Mauldin Hwy, Killen, AL 35645-9106 | 2019-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871192476 | Jacob L Turner Dmd PC | Clinic/Center | 100 A Andrew Street, Albertville, AL 35950 | 2020-10-23 |
| 1538775150 | Grants Mill Family Dentistry, LLC | Clinic/Center | 1024 Grants Mill Rd, Irondale, AL 35210-2108 | 2020-09-18 |
| 1164035341 | William M Colburn Dmd PC | Clinic/Center | 2810 20th Ave Ste A, Northport, AL 35476-3835 | 2020-08-26 |
| 1689295339 | Liles Family Dentistry, LLC | Clinic/Center | 2234 Ogletree Village Ln, Auburn, AL 36830-2967 | 2020-05-05 |
| 1184251100 | Big Wave Dentistry LLC | Clinic/Center | 110 S Alston St, Foley, AL 36535-1912 | 2020-03-27 |
| 1952934226 | Red Mountain Pediatric Dentistry | Clinic/Center | 2836 Lakeshore Pkwy, Birmingham, AL 35211-5500 | 2020-02-14 |
| 1467085837 | Brooke Jordan Dds LLC | Clinic/Center | 101 Missionary Rdg Ste 101, Birmingham, AL 35242-5203 | 2020-02-13 |
| 1881225829 | Bell Road Dentistry LLC | Clinic/Center | 2642 Bell Rd, Montgomery, AL 36117-4375 | 2020-01-29 |
| 1477199511 | Kentros Dental LLC | Clinic/Center | Pelhamdentalcare@outlook.com, 1973 Chandalar Drive, Pelham, AL 35124 | 2019-11-25 |
| 1609417195 | Rocket City Dental | Clinic/Center | 112 Lily Flagg Rd Sw Ste B, Huntsville, AL 35802-3040 | 2019-10-05 |
| Find all providers with the same taxonomy | ||||
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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.