Provider Demographics
NPI:1740453034
Name:DENTISTRY UNLIMITED P C
Entity type:Organization
Organization Name:DENTISTRY UNLIMITED P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIRKENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:256-536-8561
Mailing Address - Street 1:2310 WHITESBURG DR S
Mailing Address - Street 2:2
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3845
Mailing Address - Country:US
Mailing Address - Phone:256-536-8561
Mailing Address - Fax:256-536-8563
Practice Address - Street 1:2310 WHITESBURG DR S
Practice Address - Street 2:2
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3845
Practice Address - Country:US
Practice Address - Phone:256-536-8561
Practice Address - Fax:256-536-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL44411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51519698OtherBC/BS OF AL