Individual provider Active NPI

Jeffrey Harris Flannery Jr., D.D.S.

  • Pediatric Dentistry
  • Birmingham, AL
National Provider Identifier
1396185104
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6049 Issued in AL
Practice address
6930 Cahaba Valley Rd
Suite 200
Birmingham, AL 35242-2672
Phone
(205) 980-1338
Fax
(205) 208-9993
NPI assigned
Jun 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 6049 AL Primary

Addresses

Primary practice location

6930 Cahaba Valley Rd
Suite 200
Birmingham, AL 35242-2672

Mailing address

6930 Cahaba Valley Rd
Suite 200
Birmingham, AL 35242-2672
Phone (205) 980-1338

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
I20160111002313 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4587966361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6049ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Dentistry of Alabama Pediatric Dentistry 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1396185104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6930 CAHABA VALLEY RD",
            "address_2": "SUITE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422672",
            "telephone_number": "205-980-1338",
            "fax_number": "205-208-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 CAHABA VALLEY RD",
            "address_2": "SUITE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422672",
            "telephone_number": "205-980-1338",
            "fax_number": "205-208-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "JEFFREY",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "6049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.