Bryan T Kendricks, D.M.D., M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

D007143D Issued in AL

Practice address

Alabama Center for Oral Surgery and Dental Implants
188 N Foster St Suite 203
Dothan, AL 36303

Phone

(334) 697-6453

Fax

(334) 212-8467

NPI assigned

Apr 12, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alabama Center for Oral Surgery and Dental Implants

  • Oral and Maxillofacial Surgery Clinic/Center
  • Dothan, AL
  • NPI 1417633520
  Medicare reassignment NPD

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1477087898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 N FOSTER ST SUITE 203",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36303",
            "telephone_number": "334-697-6453",
            "fax_number": "334-212-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ALABAMA CENTER FOR ORAL SURGERY AND DENTAL IMPLANTS",
            "address_2": "188 N FOSTER ST SUITE 203",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36303",
            "telephone_number": "334-697-6453",
            "fax_number": "334-212-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICKS",
        "first_name": "BRYAN",
        "middle_name": "T",
        "credential": "D.M.D., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9978",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "D007143D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah A. Kellogg, PT, DPT
• Carrie Hanna Kelly, R.N.
• Jane C Kelly, CRNA
• Lindsay Kelly, PHARMD
• Arthur C Kendig, MD
• Anthony Braxton Kennedy, CRNP
• Christian Nicole Kennedy
• James A Kennedy, CRNA
• Savannah Kennedy
• Amy Kerecman, PTA

• Oral & Maxillofacial Surgery (D.M.D.) in Dothan, AL
• Providers in Dothan, AL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.

Verify at the official NPI Registry.