1619700911 NPI number — DR. THALYTA AMANDA PINHEIRO FERREIRA DDS

Table of content: DR. THALYTA AMANDA PINHEIRO FERREIRA DDS (NPI 1619700911)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619700911 NPI number — DR. THALYTA AMANDA PINHEIRO FERREIRA DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PINHEIRO FERREIRA
Provider First Name:
THALYTA
Provider Middle Name:
AMANDA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619700911
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1919 7TH AVENUE SOUTH SDB 315
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35294-0007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-934-4546
Provider Business Mailing Address Fax Number:
205-975-4431

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1919 7TH AVE S # SDB315
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35233-2005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-4546
Provider Business Practice Location Address Fax Number:
205-975-4431
Provider Enumeration Date:
08/22/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)