J. SHANE ROBERTS FAMILY DENTISTRY NPI 1861910036

NPI Information

NPI: 1861910036
Provider Name: J. SHANE ROBERTS FAMILY DENTISTRY
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
904 4TH ST
PLEASANT GROVE, AL
ZIP 35127
Phone: (205) 744-4258
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J. SHANE ROBERTS FAMILY DENTISTRY is a dental clinic center in Pleasant Grove, AL. J. SHANE ROBERTS FAMILY DENTISTRY NPI is 1861910036. The provider is registered as an organization entity type.

The provider's business location address is:

904 4TH ST
PLEASANT GROVE, AL
ZIP 35127-059
Phone: (205) 744-4258
Fax: (205) 744-4255

The provider's authorized official is Jerry Shane Roberts .
The authorized official title is Dentist and has the following contact phone number (205) 744-4258.

The enumeration date for this NPI number is 9/7/2017 and was last updated on 9/7/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	4013	ALABAMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	ALABAMA	GENERAL DENTIST

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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