Provider Demographics
NPI:1295428688
Name:WOOTEN, NOEL GULSBY (DMD)
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:GULSBY
Last Name:WOOTEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:NOEL
Other - Last Name:GULSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:959 S ALABAMA AVE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36460-2583
Mailing Address - Country:US
Mailing Address - Phone:251-336-9778
Mailing Address - Fax:
Practice Address - Street 1:959 S ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-2583
Practice Address - Country:US
Practice Address - Phone:251-336-9778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.007502-C1122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program