Provider Demographics
NPI:1578677233
Name:ROTHMAN, CHRISTOPHER MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:ROTHMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 VALLEYDALE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2011
Mailing Address - Country:US
Mailing Address - Phone:205-682-1099
Mailing Address - Fax:205-403-7383
Practice Address - Street 1:2290 VALLEYDALE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-2011
Practice Address - Country:US
Practice Address - Phone:205-682-1099
Practice Address - Fax:205-403-7383
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL50951223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL145050Medicaid
AL145732Medicaid
AL31711OtherBCBS PELL CITY
AL160125OtherUNITED CONCORDIA
AL31489OtherBCBS VD
AL102I194621Medicare PIN