Individual provider Active NPI

Dan L. Perry Jr., D.M.D.

  • General Practice Dentistry
  • Mobile, AL
National Provider Identifier
1336268127
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4729 Issued in AL
Practice address
4310 Old Shell Rd Ste B
Mobile, AL 36608-2046
Phone
(251) 343-1559
Fax
(251) 343-1604
NPI assigned
Mar 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4729 AL Primary

Addresses

Primary practice location

4310 Old Shell Rd Ste B
Mobile, AL 36608-2046

Mailing address

4310 Old Shell Rd Ste B
Mobile, AL 36608-2046
Phone (251) 343-1559

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
I20150713001386 AL Order and Referring Only - DentistPractitioner - Dentist 2163735655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4729ALMDGeneral Practice Dentistry
4726ALMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336268127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 OLD SHELL RD STE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082046",
            "telephone_number": "251-343-1559",
            "fax_number": "251-343-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 OLD SHELL RD STE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082046",
            "telephone_number": "251-343-1559",
            "fax_number": "251-343-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "DAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.