Individual provider Active NPI

Cory Allen Borer, D.D.S.

  • Dentist
  • Prattville, AL
National Provider Identifier
1013075969
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D.6876-C Issued in AL
Practice address
454 McQueen Smith Rd S
Prattville, AL 36066-5631
Phone
(334) 380-9170
Fax
(334) 380-9172
NPI assigned
Dec 4, 2006
Last updated
Jan 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8020 IA
Dentist 122300000X D.6876-C AL Primary

Addresses

Primary practice location

454 McQueen Smith Rd S
Prattville, AL 36066-5631

Mailing address

454 McQueen Smith Rd S
Prattville, AL 36066-5631
Phone (334) 380-9170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260417003021 AL Practitioner - Dentist 5496976490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Univ of Nebraska Medical Center, Col of Dentistry, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

330 Evergreen Dr
Deatsville, AL 36022-4420

454 McQueen Smith Rd S
Prattville, AL 36066-5631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D.6876-CALMDDentist
8020IAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cory Borer, D.D.S., LLC Current Accepting new patients
LD-Montgomery, LLC CurrentSince Jul 17, 2022 Accepting new patients
Dale Entrekin DMD PC PastSince Jul 17, 2022 Accepting new patients

Locations

7022 Vaughn Rd
Montgomery, AL 36116
Phone (334) 271-3111

454 McQueen Smith Rd S
Prattville, AL 36066
Phone (334) 277-2980

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1013075969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 MCQUEEN SMITH RD S",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665631",
            "telephone_number": "334-380-9170",
            "fax_number": "334-380-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 MCQUEEN SMITH RD S",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665631",
            "telephone_number": "334-380-9170",
            "fax_number": "334-380-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORER",
        "first_name": "CORY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "8020",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D.6876-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

Verify at the official NPI Registry.