Active NPI
Rodney D. Dellinger, DMD
- Dentist
- Cullman, AL
National Provider Identifier
1417970823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3378
- Practice address
- 210 Main Ave NW
Cullman, AL 35055-2896 - Phone
- (256) 734-2860
- Fax
- (256) 734-1094
- NPI assigned
- Jul 26, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3378 | AL | Primary |
Addresses
Primary practice location
210 Main Ave NW
Cullman, AL 35055-2896
Mailing address
210 Main Ave NW
Cullman, AL 35055-2896
Phone (256) 734-2860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91725 | Other | AL | BC/BS PROVIDER # |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151130000756 | AL | Order and Referring Only - Oral Surgery | 8123328960 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3378 | AL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1417970823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 MAIN AVE NW",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350552896",
"telephone_number": "256-734-2860",
"fax_number": "256-734-1094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 MAIN AVE NW",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350552896",
"telephone_number": "256-734-2860",
"fax_number": "256-734-1094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELLINGER",
"first_name": "RODNEY",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "3378",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER #",
"identifier": "91725",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cullman, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.