Active NPI
Daniel M Pittman III, DMD
- Periodontics
- Dothan, AL
National Provider Identifier
1053572594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 1223P0300X
- Practice address
- 103 Medical Dr
Dothan, AL 36303-6903 - Phone
- (334) 793-7232
- Fax
- (334) 712-7720
- NPI assigned
- Jun 18, 2008
- Last updated
- Jun 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 1223P0300X | AL | Primary |
Addresses
Primary practice location
103 Medical Dr
Dothan, AL 36303-6903
Mailing address
103 Medical Dr
Dothan, AL 36303-6903
Phone (334) 793-7232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5430 | Other | AL | STATE OF AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 5, 2018 through Dec 5, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1223P0300X | AL | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel M. Pittman, LLL, DMD, PC | Periodontics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Dothan Periodontics & Implants
- Periodontics
- Dothan, AL
- NPI 1629460787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213747200000",
"number": "1053572594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 MEDICAL DR",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363036903",
"telephone_number": "334-793-7232",
"fax_number": "334-712-7720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 MEDICAL DR",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363036903",
"telephone_number": "334-793-7232",
"fax_number": "334-712-7720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITTMAN",
"first_name": "DANIEL",
"middle_name": "M",
"name_suffix": "III",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-18",
"last_updated": "2008-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "AL",
"license": "1223P0300X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF AL",
"identifier": "5430",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dothan, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.