Provider Demographics
NPI:1275808438
Name:SMART DENTAL HOLDINGS, LLC
Entity Type:Organization
Organization Name:SMART DENTAL HOLDINGS, LLC
Other - Org Name:CAHABA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-477-4242
Mailing Address - Street 1:5751 POCAHONTAS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-5476
Mailing Address - Country:US
Mailing Address - Phone:205-928-3094
Mailing Address - Fax:
Practice Address - Street 1:223 PIERSON AVE
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:AL
Practice Address - Zip Code:35042-2919
Practice Address - Country:US
Practice Address - Phone:205-926-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCCALLA FAMILY DENTISTRY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-20
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5345122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty