Provider Demographics
NPI:1831257781
Name:CHILDERS, NOEL KARL (DDS)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:KARL
Last Name:CHILDERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 7TH AVE S SDB BOX 58 1
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294
Mailing Address - Country:US
Mailing Address - Phone:205-934-2340
Mailing Address - Fax:205-934-7899
Practice Address - Street 1:1919 7TH AVE S
Practice Address - Street 2:1600 7TH AVE S CLINIC 9
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0007
Practice Address - Country:US
Practice Address - Phone:205-934-3230
Practice Address - Fax:205-934-7013
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38321223P0221X
FL81301223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00687472OtherCOMP. BENEFITS
AL3832OtherDELTA DENTAL
AL90556OtherBCBS PROVIDER