Provider Demographics
NPI:1629602529
Name:SUMMIT SMILES PEDIATRIC DENTISTRY, LLC
Entity type:Organization
Organization Name:SUMMIT SMILES PEDIATRIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST (PEDODONTIST)
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:GUNNELS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:251-455-9787
Mailing Address - Street 1:4213 DOLLY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5703
Mailing Address - Country:US
Mailing Address - Phone:205-490-6850
Mailing Address - Fax:205-449-0292
Practice Address - Street 1:4213 DOLLY RIDGE RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5703
Practice Address - Country:US
Practice Address - Phone:205-490-6850
Practice Address - Fax:205-449-0292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty