Jaclyn Bates Alison, DMD
Individual provider Active NPI Dentist · Pelham, AL
NPI 1033748348 · NPPES record last updated May 28, 2024
Key facts
- NPI
- 1033748348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D-0006940-C1 (AL)
- Practice address
- 1973 Chandalar Dr
Pelham, AL 35124-4359 - Phone
- (206) 524-1600
- Fax
- (206) 524-1603
- NPI assigned
- Apr 7, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-0006940-C1 | AL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peregrine Pacific Anesthesia PLLC | Past |
Accepting new patients | |
| Winston & Letwin DDS, PLLC | Past |
Accepting new patients |
Interoperability endpoints
- jbates89962@direct.seattlechildrens.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D-0006940-C1 | AL | Yes |
Addresses
Primary practice location
1973 Chandalar Dr
Pelham, AL 35124-4359
Mailing address
2228 Garland Dr
Vestavia Hills, AL 35216-2435
Phone (205) 587-4774
Other names
- Jaclyn Elizabeth Bates
Other providers in Pelham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.