Active NPI
Lior Aljadeff, D.D.S, M.D.
- Oral & Maxillofacial Surgery (D.M.D.)
- Jbsa Lackland, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- 32373
- Practice address
- 1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638 - Phone
- (210) 292-7878
- NPI assigned
- Jun 5, 2015
- Last updated
- Jun 24, 2024
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 2901021581 | MI | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | D-0007036-C | AL | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 42397 | AL | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | U5913 | TX | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 32373 | TX | Primary |
Addresses
Primary practice location
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Mailing address
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Other practice location 1
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 292-7878
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32373 | TX | MD | Counseling Psychologist |
| D-0007036-C | AL | MD | Oral and Maxillofacial Surgery (Dentist) |
| 2901021581 | MI | MD | Oral and Maxillofacial Surgery (Dentist) |
| U5913 | TX | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Alabama Health Services Foundation, PC. | Current | Accepting new patients |
Locations
619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405
619 19th St S
Birmingham, AL 35249
501 Emery Dr W
Hoover, AL 35244
Phone (205) 801-7703
Interoperability endpoints
- laljadeff@direct.uabmedicine.org
- laljadeff45946@direct.phhs.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Birmingham, AL
- NPI 1093768723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1285014084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-292-7878"
}
],
"practiceLocations": [
{
"address_1": "3551 Roger Brooke Dr",
"address_purpose": "LOCATION",
"city": "Jbsa Ft Sam Houston",
"state": "TX",
"postal_code": "782344504",
"country_code": "US",
"telephone_number": "210-292-7878",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALJADEFF",
"first_name": "LIOR",
"name_prefix": "Dr.",
"credential": "D.D.S, M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-05",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "MI",
"license": "2901021581",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "AL",
"license": "D-0007036-C",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "AL",
"license": "42397",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "TX",
"license": "U5913",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "TX",
"license": "32373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.