# NORTH JEFFERSON PEDIATRIC DENTISTRY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Amy T. Parvin, D.M.D.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043351950
- **Authorized official:** MRS. SELENA D DEVINE (OFFICE MANAGER)
- **Authorized official phone:** (205) 631-2240

## Contact information

- **Practice address:** 925 SHARIT AVE, STUITE 113, GARDENDALE, AL 35071-5000
- **Practice address phone:** (205) 631-2240
- **Practice address fax:** (205) 631-1611
- **Mailing address:** 925 SHARIT AVE, STUITE 113, GARDENDALE, AL 35071-5000
- **Mailing address phone:** (205) 631-2240
- **Mailing address fax:** (205) 631-1611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 4970 | AL | Yes |

## Other

- **Enumeration date:** 02/12/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1356891 | UCCI | AL |
| 01 | — | 51531288 | BCBS OF ALABAMA | AL |