William Henry Pendleton, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4398 Issued in AL

Practice address

6905 Atlanta Hwy
Montgomery, AL 36117-4213

Phone

(334) 270-1414

Fax

(334) 270-0053

NPI assigned

Feb 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

State licenses

Practice roles

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.

• JRL, DMD, LLC

  • Dental Clinic/Center
  • Montgomery, AL
  • NPI 1013531532
  NPD (past)

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487780631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6905 ATLANTA HWY",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361174213",
            "telephone_number": "334-270-1414",
            "fax_number": "334-270-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 ATLANTA HWY",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361174213",
            "telephone_number": "334-270-1414",
            "fax_number": "334-270-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "WILLIAM",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatrics at Twilight,LLC
• Emily Pell, MA CCC-SLP
• Ann Pemberton
• Linda Pena-Resto, LISW-CP
• Victor E Pena, MD
• Yao Peng, MD
• Alexa Penn, RN
• Shandra Penn
• E. Gray Penton, DMD
• Shearlyn Deanne Peoples, M.D.

• General Practice Dentistry in Montgomery, AL
• Providers in Montgomery, AL by specialty
• General Practice Dentistry in Alabama

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

Verify at the official NPI Registry.