Jacob Paul Alexander, DDS – Dentist in Fairhope, AL

Key facts

NPI: 1013757244
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: D.007298-C1 (AL)
Practice address: 23678 US Highway 98
Fairhope, AL 36532-3336
Phone: (251) 928-8770
NPI assigned: May 27, 2024
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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

Northcutt Dental Practice General Practice Dentistry · Fairhope, AL · NPI 1295890515

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AL
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240805000522	AL	Order and Referring Only - Dentist Practitioner - Dentist	0143767400

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
D.007298-C1	AL	MD	Dentist

Practice roles

Organization	Specialty	Status	New patients
Northcutt Dental Practice		Past since Jun 2, 2024	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	D.007298-C1	AL	Yes

Addresses

Primary practice location

23678 US Highway 98
Fairhope, AL 36532-3336

Mailing address

23678 US Highway 98
Fairhope, AL 36532-3336
Phone (225) 588-7221

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 14, 2024.

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1013757244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23678 US HIGHWAY 98",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323336",
            "telephone_number": "225-588-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23678 US HIGHWAY 98",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323336",
            "telephone_number": "251-928-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "JACOB",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D.007298-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

All providers in Fairhope, AL · Dentist in Alabama

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.