COMPLETE DENTAL DECATUR LLC (NPI# 1366794711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366794711 |
| Entity Type | Organization |
| Organization Name | COMPLETE DENTAL DECATUR LLC |
| Practice Address |
1241 Point Mallard Parkway Suite. 105 Decatur AL 35601 |
| Mailing Address |
120 W Dublin Dr Suite. 202 Madison AL 35758-3155 |
| Practice Telephone | 2562583866 |
| Mailing Telephone | 2562583866 |
| Mailing Fax Number | 2564645763 |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |
| Authorized Official Name | MRS. TERESA JANETTE HAAKE (BILLING COORDINATOR) |
| Authorized Official Telephone | 2562583883 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5311 | AL | Dental Providers |
| Street Address |
1241 POINT MALLARD PARKWAY SUITE. 105 |
| City | DECATUR |
| State | AL |
| Zip Code | 35601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1336408830 | Mishanta Reyes | Obstetrics & Gynecology | 1215 7th St Se Fl 2, Decatur, AL 35601 | 2012-05-04 |
| Find all providers in zip 35601 | ||||
| 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 |
|---|---|---|---|---|
| 1548870884 | Daniel Patrick Jurgens | Dentist | 2 N Country Club Rd Ste 2, Decatur, IL 62521-4174 | 2020-08-02 |
| 1134744576 | Dafna Lapidot | Dentist | 1074 Vistavia Cir, Decatur, GA 30033-3413 | 2020-06-11 |
| 1184140121 | Access Dental Care, LLC | Dentist | 1621 Wolverine Dr Se, Decatur, AL 35601-4933 | 2017-08-22 |
| 1154868917 | North Decatur Dentistry, PC | Dentist | 2570 Blackmon Drive, Suite 320, Decatur, GA 30033 | 2017-01-31 |
| 1245645084 | Mobile Dental Services of Alabama PC | Dentist | 3231 Fieldstone Dr Sw, Decatur, AL 35603-3173 | 2014-06-30 |
| 1619317518 | Jieun Jun | Dentist | 2450 Lawrenceville Hwy Ste 100, Decatur, GA 30033-3269 | 2013-06-25 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
| 1598092801 | Brandon Michael Piper | Dentist | 469 W Wood St, Decatur, IL 62522-3109 | 2009-11-06 |
| 1952530131 | Jassen Allen Anthony | Dentist | 466 Highway 67 S, Decatur, AL 35603-6300 | 2009-07-08 |
| Find all providers in DECATUR | ||||
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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.