Active NPI
Andrew Jason Lange, DMD
- General Practice Dentistry
- Birmingham, AL
National Provider Identifier
1164737391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5760
- Practice address
- 1930 Edwards Lake Rd
Suite 134
Birmingham, AL 35235-3718 - Phone
- (205) 655-8090
- NPI assigned
- Aug 12, 2010
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5760 | AL | Primary |
Addresses
Primary practice location
1930 Edwards Lake Rd
Suite 134
Birmingham, AL 35235-3718
Mailing address
1930 Edwards Lake Rd
Suite 134
Birmingham, AL 35235-3718
Phone (205) 655-8090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5760 | AL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lange Family Dentistry, LLC | General Practice | 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.
-
- General Practice Dentistry
- Birmingham, AL
- NPI 1225384746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294876800000",
"number": "1164737391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 EDWARDS LAKE RD",
"address_2": "SUITE 134",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352353718",
"telephone_number": "205-655-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 EDWARDS LAKE RD",
"address_2": "SUITE 134",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352353718",
"telephone_number": "205-655-8090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "ANDREW",
"middle_name": "JASON",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-12",
"last_updated": "2011-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "5760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.