Provider Demographics
NPI:1073095212
Name:AFFORDABLE DENTURES & IMPLANTS - BIRMINGHAM-HOOVER, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - BIRMINGHAM-HOOVER, P.C.
Other - Org Name:AFFORDABLE DENTURES & IMPLANTS - BIRMINGHAM-HOOVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:205-338-2915
Mailing Address - Street 1:5239 HIGHWAY 280
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5315
Mailing Address - Country:US
Mailing Address - Phone:205-338-2915
Mailing Address - Fax:
Practice Address - Street 1:5239 HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5315
Practice Address - Country:US
Practice Address - Phone:205-338-2915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty