Individual provider Active NPI

Daniel Christopher Picard, D.M.D., L.L.C.

  • General Practice Dentistry
  • Talladega, AL
National Provider Identifier
1154418762
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5172 Issued in AL
Practice address
1202 Ashland Hwy
Talladega, AL 35160-3109
Phone
(256) 362-4343
Fax
(256) 362-4942
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5172 AL Primary

Addresses

Primary practice location

1202 Ashland Hwy
Talladega, AL 35160-3109

Mailing address

1202 Ashland Hwy
Talladega, AL 35160-3109
Phone (256) 362-4343

Other identifiers 2

IdentifierTypeStateIssuer
1668132OtherALUNITED CONCORDIA PROV ID
515-25364OtherALBCBS PROVIDER ID

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
I20170118000707 AL Order and Referring Only - DentistPractitioner - Dentist 0840572343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5172ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Keith a. Williamson, MD, LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154418762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 ASHLAND HWY",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351603109",
            "telephone_number": "256-362-4343",
            "fax_number": "256-362-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 ASHLAND HWY",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351603109",
            "telephone_number": "256-362-4343",
            "fax_number": "256-362-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICARD",
        "first_name": "DANIEL",
        "middle_name": "CHRISTOPHER",
        "credential": "D.M.D., L.L.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROV ID",
            "identifier": "1668132",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "515-25364",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Talladega, AL

Sources for this page

Verify at the official NPI Registry.