Healthcare Provider Details

I. General information

NPI: 1831012285
Provider Name (Legal Business Name): SPRINGVILLE CHILDREN'S DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 09/10/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 SPRINGVILLE STATION BLVD
SPRINGVILLE AL
35146-9998
US

IV. Provider business mailing address

2425 MEDICAL CENTER PARKWAY
SELMA AL
36701-7756
US

V. Phone/Fax

Practice location:
  • Phone: 334-875-1330
  • Fax: 205-859-8553
Mailing address:
  • Phone: 334-875-1330
  • Fax: 334-875-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH CULEPEPPER
Title or Position: LICENSING, CREDENTIALING AND COMPLI
Credential:
Phone: 334-875-1330