Provider Demographics
NPI:1053349472
Name:CURTIS, JONATHAN C (DMD, MPH)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:C
Last Name:CURTIS
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 NARROWS DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-8627
Mailing Address - Country:US
Mailing Address - Phone:205-408-8889
Mailing Address - Fax:205-408-8187
Practice Address - Street 1:141 NARROWS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-8627
Practice Address - Country:US
Practice Address - Phone:205-408-8889
Practice Address - Fax:205-408-8187
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL52631223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-31019OtherBC/BS ID #
AL009934268Medicaid
AL20-2245244OtherDELTA DENTAL/TIN