Individual provider Active NPI

Charles Alexander Estrada, DMD

  • Dentist
  • Huntsville, AL
National Provider Identifier
1316676729
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D-0007087-C1 Issued in AL
Practice address
751 Pleasant Row NW
Huntsville, AL 35816-2537
Phone
(256) 533-6311
NPI assigned
Jun 9, 2022
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D-0007087-C1 AL Primary

Addresses

Primary practice location

751 Pleasant Row NW
Huntsville, AL 35816-2537

Mailing address

4073 Braeswood Dr SW Apt 2
Huntsville, AL 35802-4157
Phone (609) 969-1596

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130002055 AL Practitioner - Dentist 3870941891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-0007087-C1ALMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Central North Alabama Health Services, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Central North Alabama Health Services, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

751 Pleasant Row NW
Huntsville, AL 35816
Phone (256) 533-6311

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1316676729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4073 BRAESWOOD DR SW APT 2",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024157",
            "telephone_number": "609-969-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 PLEASANT ROW NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358162537",
            "telephone_number": "256-533-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "CHARLES",
        "middle_name": "ALEXANDER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D-0007087-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.