Danielle Outlaw, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-0006995-C1 Issued in AL

Practice address

111 B Y Williams Sr Dr
Midfield, AL 35228-2218

Phone

(205) 923-3172

NPI assigned

Jul 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Danielle Lauren Outlaw-Peterson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1285156604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GREYSTONE GLEN DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352427105",
            "telephone_number": "409-719-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 B Y WILLIAMS SR DR",
            "city": "MIDFIELD",
            "state": "AL",
            "postal_code": "352282218",
            "telephone_number": "205-923-3172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Covington Pike Ste 150",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381285041",
            "country_code": "US",
            "telephone_number": "901-310-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "DANIELLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12339",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0006995-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "OUTLAW-PETERSON",
            "middle_name": "LAUREN",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Secure Transporation

• All providers in Midfield, AL
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.