Robert Larkin Deshazer, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3495 Issued in AL

Practice address

2501 Stemley Bridge Rd
Pell City, AL 35128-7525

Phone

(205) 884-1691

Fax

(205) 338-6921

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 13, 2017 through Mar 13, 2027

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.

• Dr. Robert Deshazer , D.M.D PC

  • General Practice Dentistry
  • Pell City, AL
  • NPI 1326556408
  NPD (past) Authorized official

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497798060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 STEMLEY BRIDGE RD",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351287525",
            "telephone_number": "205-884-1691",
            "fax_number": "205-338-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 STEMLEY BRIDGE RD",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351287525",
            "telephone_number": "205-884-1691",
            "fax_number": "205-338-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHAZER",
        "first_name": "ROBERT",
        "middle_name": "LARKIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Davis, DPT
• Jamaiya Davis, RN
• Jennifer Degaris
• Danielle Deluca
• Elizabeth McCalman Dennis, DMD
• Dialysis Clinic Inc.
• Diversicare of Pell City, LLC
• Elisabeth May Douglass, DPT
• Dr. Robert Deshazer , D.M.D PC
• Dr. Sandra T. Lanter

• General Practice Dentistry in Pell City, AL
• Providers in Pell City, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.