NPIMap

Organization Active NPI

Robert T Underwood DMD PC

  • Dentist
  • Gardendale, AL
National Provider Identifier
1487013298
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4885 Issued in AL
Legal business name
ROBERT T UNDERWOOD DMD PC
Practice address
1038 Mount Olive Rd
Gardendale, AL 35071-3443
Phone
(205) 631-8066
Fax
(205) 631-8021
NPI assigned
Feb 22, 2016
Last updated
Feb 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Authorized official

Name
Dr. Robert UnderwoodNPI 1841371929
Title
Owner
Phone
(205) 631-8066

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4885 AL Primary

Addresses

Primary practice location

1038 Mount Olive Rd
Gardendale, AL 35071-3443

Mailing address

1038 Mount Olive Rd
Gardendale, AL 35071-3443
Phone (205) 631-8066

Other identifiers 3

IdentifierTypeStateIssuer
009924885MedicaidAL
51096265OtherALBLUE CROSS BLUE SHIELD OF AL
1841371929OtherALNPI

National Provider Directory

National Provider Directory

Locations

1038 Mount Olive Rd
Gardendale, AL 35071
Phone (205) 631-8066

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456099200000",
    "number": "1487013298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 MOUNT OLIVE RD",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350713443",
            "telephone_number": "205-631-8066",
            "fax_number": "205-631-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 MOUNT OLIVE RD",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350713443",
            "telephone_number": "205-631-8066",
            "fax_number": "205-631-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT T UNDERWOOD DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-02-22",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-631-8066",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "4885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009924885",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF AL",
            "identifier": "51096265",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841371929",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardendale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.