COASTAL PERIODONTICS & IMPLANT DENTISTRY, PC (NPI# 1619068822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619068822 |
| Entity Type | Organization |
| Organization Name | COASTAL PERIODONTICS & IMPLANT DENTISTRY, PC |
| Practice Address |
505 Georgian Drive Ste A Mobile AL 36609 |
| Practice Telephone | 2513421644 |
| Practice Fax Number | 2513421648 |
| Mailing Telephone | 2513421644 |
| Mailing Fax Number | 2513421648 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2018-01-25 |
| Authorized Official Name | DR. HARRIS R BROWN (PRESIDENT) |
| Authorized Official Telephone | 2513421644 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Street Address |
505 GEORGIAN DRIVE STE A |
| City | MOBILE |
| State | AL |
| Zip Code | 36609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698309 | Bhg Lxxii, LLC | Clinic/Center | 4373 Dowtowner Loop South, Suite A, Mobile, AL 36609 | 2020-10-26 |
| 1760036008 | Jesse David Schultz | Chiropractor | 3501 Montlimar Plaza Drive, Mobile, AL 36609 | 2019-07-25 |
| 1982267241 | Raqueal L. Williams | Registered Nurse | 406 Larose Dr., Mobile, AL 36609 | 2019-04-22 |
| 1588131924 | Angela Roney | Counselor | 705 Oak Circle Dr. East, Mobile, AL 36609 | 2018-10-24 |
| 1134617996 | Harley Michelle Oliver | Physician Assistant | 820 S. University Blvd Bldg 1, Suite 1b, Mobile, AL 36609 | 2018-04-27 |
| 1912420126 | Rural Urgent Care LLC | Clinic/Center | 6280 Grelot Road, Mobile, AL 36609 | 2017-07-19 |
| 1598128407 | Trisha Mcmillon | Counselor | 3929 Airport Blvd Ste 1-214, Mobile, AL 36609 | 2016-03-30 |
| 1437523347 | Sonya White D.d.s. PC | Dentist | 6309 Piccadilly Square Dr., Mobile, AL 36609 | 2015-11-17 |
| 1386913374 | Janis Marie Fausser | Pharmacist | 5705 Cottagehill Rd, Mobile, AL 36609 | 2011-12-20 |
| 1245524263 | Emily Chisholm | Physical Therapist | 1515 University Blvd. S., Mobile, AL 36609 | 2011-06-07 |
| Find all providers in zip 36609 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194814459 | Jason Bradley Simmons | Dentist | 6337 Piccadilly Square Dr, Mobile, AL 36609-5103 | 2006-10-12 |
| 1942391156 | James Robert Woodall | Dentist | 505 Georgian Dr, Ste A, Mobile, AL 36609 | 2006-09-27 |
| 1043298698 | Jon N Bowie | Dentist | 829 S University Blvd, Mobile, AL 36609-7873 | 2006-01-04 |
| 1851482061 | Harris Radcliff Brown | Dentist | 505 Georgian Dr, Ste A, Mobile, AL 36609 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508489709 | Kevin M. Sims, Dmd, Ms, PC | Dentist | 2074 Valleydale Rd, Hoover, AL 35244-2084 | 2020-05-21 |
| 1619599297 | Alabama Dental Specialist LLC | Dentist | 4501 Southlake Pkwy Ste 201, Hoover, AL 35244-3644 | 2020-05-18 |
| 1467964544 | Jamie Hargett Howard | Dentist | 418 School of Dentistry Building, 1919 7th Ave S, Birmingham, AL 35233 | 2017-10-30 |
| 1770028532 | George Britt | Dentist | 5104 Cyrus Cir, Birmingham, AL 35242-4630 | 2017-01-03 |
| 1407043797 | Jack Holmes Reid Jr. | Dentist | 911 Plantation Blvd, Fairhope, AL 36532-2949 | 2007-10-01 |
| 1568660231 | Scott Edmund Atkinson | Dentist | 621 Helen Keller Blvd Ste 200, Tuscaloosa, AL 35404-2962 | 2007-07-04 |
| 1396947818 | Maria L Geisinger | Dentist | 121 Peachtree Rd, Birmingham, AL 35213-2930 | 2007-06-05 |
| 1790812030 | John M. Lane | Dentist | 1912 Bruin Dr, Florence, AL 35630-6769 | 2007-02-27 |
| 1134280712 | Brett Maddux | Dentist | 3240 Edwards Lake Pkwy Ste 200, Birmingham, AL 35235-3128 | 2006-12-13 |
| 1154489409 | George N Britt Dmd Pa | Dentist | 5104 Cyrus Circle, Birmingham, AL 35242 | 2006-12-05 |
| 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.