Provider Demographics
NPI:1982292918
Name:ORTHODONTICS WEST P.C.
Entity Type:Organization
Organization Name:ORTHODONTICS WEST P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-798-6096
Mailing Address - Street 1:1436 BEAUTY CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35214-3008
Mailing Address - Country:US
Mailing Address - Phone:120-579-8609
Mailing Address - Fax:
Practice Address - Street 1:1436 BEAUTY CIR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35214-3008
Practice Address - Country:US
Practice Address - Phone:205-798-6096
Practice Address - Fax:205-798-6096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty