Jerald Allen Dixon Jr., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4505 Issued in AL

Practice address

224 Shelton Beach Rd
Saraland, AL 36571-2754

Phone

(251) 675-3354

Fax

(251) 675-3451

NPI assigned

Oct 11, 2006

Sex

Male

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

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164511127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 SHELTON BEACH RD",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365712754",
            "telephone_number": "251-675-3354",
            "fax_number": "251-675-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SHELTON BEACH RD",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365712754",
            "telephone_number": "251-675-3354",
            "fax_number": "251-675-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "JERALD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Paul Crenshaw, MD
• D and F of Saraland PC
• D H Supply, Inc.
• Amy Renee Davis, NP
• Ronda Coleman Davis
• John L Dixon, MD
• Angela Lanham Ellison, LPC
• Encore Rehabilitation, Inc.
• Whitney Vautier Engheta, D.O.
• Exhale With Erica LLC

• General Practice Dentistry in Saraland, AL
• Providers in Saraland, 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 Jul 8, 2007; 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.