Active NPI
Andrew Rolland Duckett, D.M.D.
- Periodontics
- Birmingham, AL
National Provider Identifier
1497835391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 4629
- Practice address
- 1830 14TH Ave S
Birmingham, AL 35205-4969 - Phone
- (205) 933-5511
- Fax
- (205) 939-0150
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 4629 | AL | Primary |
Addresses
Primary practice location
1830 14TH Ave S
Birmingham, AL 35205-4969
Mailing address
1830 14TH Ave S
Birmingham, AL 35205-4969
Phone (205) 933-5511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4629 | AL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497835391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 14TH AVE S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352054969",
"telephone_number": "205-933-5511",
"fax_number": "205-939-0150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 14TH AVE S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352054969",
"telephone_number": "205-933-5511",
"fax_number": "205-939-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCKETT",
"first_name": "ANDREW",
"middle_name": "ROLLAND",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "AL",
"license": "4629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.