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GARDENDALE ORAL SURGERY, P.C.
NPI 1336632561
Dentist - Oral and Maxillofacial Surgery in Gardendale, AL

Active since June 12, 2018
919 SHARIT AVE STE 201, GARDENDALE, AL 35071(205) 631-4004(205) 631-4007 Get Directions Write a Review

NPPES record last updated: July 5, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 5, 2018, Jun 12, 2018 (2 updates tracked since 2018).

About Gardendale Oral Surgery, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARDENDALE ORAL SURGERY, P.C. (NPI 1336632561) is a healthcare organization registered as an oral and maxillofacial surgery in Gardendale, Alabama and active in the NPI registry since June 2018. The organization lists Justin D Lackey, Front Office, as its authorized official.

NPPES Registry Identity

NPI1336632561
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameGARDENDALE ORAL SURGERY, P.C.
Location Address919 SHARIT AVE STE 201Gardendale, AL 35071
Mailing Address919 Sharit Ave Ste 201Gardendale, AL 35071-5008 · (205) 631-4004 · Fax (205) 631-4007
Phone(205) 631-4004
Fax(205) 631-4007
Organization SubpartNo
Authorized OfficialJustin D LackeyFront Office · (256) 595-2131
Enumeration DateJune 12, 2018
Last NPPES UpdateJuly 5, 20182 updates tracked since enumeration
✔ NPI 1336632561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
919 SHARIT AVE STE 201, Gardendale, AL 35071
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Other Identifiers 1

Medicaid216971AL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gardendale Oral Surgery, P.C.'s NPI number?

The NPI number for Gardendale Oral Surgery, P.C. is 1336632561. It was assigned to this organization in the NPPES registry on June 12, 2018.

Where is Gardendale Oral Surgery, P.C. located?

Gardendale Oral Surgery, P.C. is located at 919 Sharit Ave Ste 201, Gardendale, AL 35071. The listed phone number is (205) 631-4004.

What is Gardendale Oral Surgery, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

What insurance does Gardendale Oral Surgery, P.C. accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and UnitedHealthcare list Gardendale Oral Surgery, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gardendale Oral Surgery, P.C. was last updated on July 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.