Healthcare Provider Details

I. General information

NPI: 1063215689
Provider Name (Legal Business Name): SETH HOFHEINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2025
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1572 MILL SQ
ALEXANDER CITY AL
35010-2674
US

IV. Provider business mailing address

519 GAIETY LN
IRONDALE AL
35210-3325
US

V. Phone/Fax

Practice location:
  • Phone: 256-397-1050
  • Fax: 256-397-1051
Mailing address:
  • Phone: 573-578-6617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD.007587-C1
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: