Individual provider Active NPI

Andrew Bertot

  • Dentist
  • Birmingham, AL
National Provider Identifier
1336726181
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0006971-C1 Issued in AL
Practice address
625 19TH St S
Birmingham, AL 35233-1900
Phone
(205) 934-5334
NPI assigned
Mar 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0006971-C1 AL Primary

Addresses

Primary practice location

625 19TH St S
Birmingham, AL 35233-1900

Mailing address

625 19TH St S
Birmingham, AL 35233-1900

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
I20210517001665 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2567871890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0006971-C1ALMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1336726181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-934-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOT",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "0006971-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.