Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Roots Family and Cosmetic Dentistry

Organization Dental Clinic/Center · NPI 1336973999

Southern Roots Family and Cosmetic Dentistry is a Dental Clinic/Center in Mobile, Alabama. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

6154 Omni Park Dr
Mobile, AL 36609-5195
Phone: (251) 414-5142
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1336973999
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Walter Vickers — Owner · (251) 342-0380
NPI enumeratedAugust 27, 2024
Last updated in NPPESSeptember 18, 2024
Certification dateSeptember 18, 2024
Mailing address6154 Omni Park Dr, Mobile, AL 36609-5195

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