Individual provider Active NPI

Laurie McCullough Estes, DDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Albany, CA
National Provider Identifier
1235417858
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DDS62336 Issued in CA
Practice address
591 San Pablo Ave
Albany, CA 94706-1126
Phone
(510) 525-1772
Fax
(510) 525-3157
NPI assigned
Jul 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X DDS62336 CA Primary

Addresses

Primary practice location

591 San Pablo Ave
Albany, CA 94706-1126

Mailing address

591 San Pablo Ave
Albany, CA 94706-1126
Phone (510) 525-1772

Other names 1

  • Dr. Laurie Katharine McCullough Former name

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

LicenseStateTypeSpecialty
DDS62336CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Laurie M. Estes, DDS, Inc. Orthodontics and Dentofacial Orthopedics PastSince Jul 24, 2022 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": "1312070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235417858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061126",
            "telephone_number": "510-525-1772",
            "fax_number": "510-525-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061126",
            "telephone_number": "510-525-1772",
            "fax_number": "510-525-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTES",
        "first_name": "LAURIE",
        "middle_name": "MCCULLOUGH",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS62336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "MCCULLOUGH",
            "middle_name": "KATHARINE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.