Individual provider Active NPI

Dale Edwin Allen, D.M.D.

  • Public Health Dentistry
  • Madison, AL
National Provider Identifier
1376707869
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
4066 Issued in AL
Practice address
7898 Madison Pike
Madison, AL 35758-1435
Phone
(256) 461-9970
Fax
(256) 461-8169
NPI assigned
Jul 14, 2008
Last updated
Jul 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 4066 AL Primary

Addresses

Primary practice location

7898 Madison Pike
Madison, AL 35758-1435

Mailing address

7898 Madison Pike
Madison, AL 35758-1435
Phone (256) 461-9970

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
I20170422000213 AL Order and Referring Only - DentistPractitioner - Dentist 1355627654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4066ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Dental Associates, P.C. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1376707869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7898 MADISON PIKE",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581435",
            "telephone_number": "256-461-9970",
            "fax_number": "256-461-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7898 MADISON PIKE",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581435",
            "telephone_number": "256-461-9970",
            "fax_number": "256-461-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "DALE",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "AL",
            "license": "4066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.