William Manley Colburn, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4358 Issued in AL

Practice address

2810 20TH Ave
Suite a
Northport, AL 35476-3835

Phone

(205) 339-1777

Fax

(205) 339-8200

NPI assigned

Oct 24, 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

Practice roles

Locations

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.

• William M Colburn DMD PC

  • Dental Clinic/Center
  • Northport, AL
  • NPI 1164035341
  NPD Authorized official

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1275617680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 20TH AVE",
            "address_2": "SUITE A",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763835",
            "telephone_number": "205-339-1777",
            "fax_number": "205-339-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 20TH AVE",
            "address_2": "SUITE A",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763835",
            "telephone_number": "205-339-1777",
            "fax_number": "205-339-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "WILLIAM",
        "middle_name": "MANLEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Ann Norris Clowers, CRNP
• Lauren Payne Cobb, D.C.
• Coburn Inc (Natural RX)
• Jordan Rae Cochran Hodges, PHARMD
• Robert Maynard Colburn Jr., RPH
• Colburn's Northport Pharmacy, Inc. (Northport Pharmacy)
• Colburn's Northport Pharmacy, Inc.
• Cole Counseling, LLC
• Heather Marie Cole, LICSW, LCSW
• Lewis C Cole, DMD

• General Practice Dentistry in Northport, AL
• Providers in Northport, 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 Mar 28, 2016; 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.