# CHILDREN AND TEEN DENTAL GROUP OF ALABAMA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508345828
- **Authorized official:** BRIAN SMITH (CFO)
- **Authorized official phone:** (770) 231-5348

## Contact information

- **Practice address:** 323 FIELDSTOWN RD STE 101, GARDENDALE, AL 35071-2531
- **Practice address phone:** (205) 631-4572
- **Mailing address:** 2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
- **Mailing address phone:** (470) 207-3264

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/08/2018
- **Last updated:** 05/20/2026