Trella C. Dutton, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4640 Issued in AL

Practice address

12205 County Line Rd
Suite a
Madison, AL 35758-7718

Phone

(256) 425-0179

Fax

(256) 425-0183

NPI assigned

Feb 15, 2008

Last updated

Feb 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oasis Dental Services

  • Dental Clinic/Center
  • Madison, AL
  • NPI 1649439761
  NPD (past) Authorized official

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1033387758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12205 COUNTY LINE RD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587718",
            "telephone_number": "256-425-0179",
            "fax_number": "256-425-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12205 COUNTY LINE RD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587718",
            "telephone_number": "256-425-0179",
            "fax_number": "256-425-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "TRELLA",
        "middle_name": "C.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Dussor, RN
• Jennifer Cook Duster, LICSW, PIP, LLC
• Dutton Dental, LLC (Dutton Dental)
• Emily Rae Dutton, NP-C
• Ethan Dutton
• Michael David Dye, A.T.C.
• Dynamic Performance Therapy and Rehabilitation, Inc (Dynamic Performance Physical Therapy)
• E a McCleskey, DO, LLC
• Early Interactions, LLC
• Hannah Earnst

• General Practice Dentistry in Madison, AL
• Providers in Madison, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.