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General NPI Number Information
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NPI Number | 1881132710
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Entity Type | Individual
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Provider Name | JOSHUA RAY HEADLEY D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2017
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1700 6TH AVE N
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City | BESSEMER
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State | AL
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Zip | 35020-4849
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Country | US
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Telephone | 205-434-2031
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 EDGEWOOD BLVD
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City | HOMEWOOD
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State | AL
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Zip | 35209-5343
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Country | US
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Telephone | 205-908-0193
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D.0006431-C1
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License Number State | AL
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