| Name: | Dr. Lonette S. Phipps L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 13 Feb 2001 (24 years ago) (Companies founded in February 2001) |
| Entity Number: | 000-674-155 |
| Register Number: | 000674155 |
| ZIP code: | 35208 (Companies in Jefferson, 35208) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 2152-46TH PL ENSBIRMINGHAM, AL 35208 |
Activities
DENTAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710163258 | 2008-01-15 | 2008-01-15 | 2152 46TH PLACE ENSLEY, BIRMINGHAM, AL, 352084602, US | 2152 46TH PLACE ENSLEY, BIRMINGHAM, AL, 352084602, US | |||||||||||||||||||||||||
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| Phone | +1 205-788-8889 |
| Fax | 2087888890 |
Authorized person
| Name | MR. BENNIE L PHIPPS |
| Role | CEO |
| Phone | 2057888889 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | 5045 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51538521 |
| State | AL |
| Name | Role |
|---|---|
| PHIPPS, LONETTE S | Agent |
| Name | Role |
|---|---|
| PHIPPS, LONETTE S | Member |
| PHIPPS, BENNIE L | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
