Active NPI
Dino C Jacovides, DMD
- Dentist
- Vestavia, AL
National Provider Identifier
1497940167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4166
- Practice address
- 3142 Cuhaba Heights Rd
Vestavia, AL 35243 - Phone
- (205) 970-1866
- Fax
- (205) 970-1896
- NPI assigned
- Sep 6, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4166 | AL | Primary |
Addresses
Primary practice location
3142 Cuhaba Heights Rd
Vestavia, AL 35243
Mailing address
3142 Cuhaba Heights Rd
Vestavia, AL 35243
Phone (205) 970-1866
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1303418 | Other | AL | UNITED CONCORDIA |
| 40992 | Other | AL | BC BS OF AL |
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 |
|---|---|---|---|
| 4166 | AL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189036800000",
"number": "1497940167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3142 CUHABA HEIGHTS RD",
"city": "VESTAVIA",
"state": "AL",
"postal_code": "35243",
"telephone_number": "205-970-1866",
"fax_number": "205-970-1896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3142 CUHABA HEIGHTS RD",
"city": "VESTAVIA",
"state": "AL",
"postal_code": "35243",
"telephone_number": "205-970-1866",
"fax_number": "205-970-1896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOVIDES",
"first_name": "DINO",
"middle_name": "C",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-06",
"last_updated": "2007-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "4166",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1303418",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF AL",
"identifier": "40992",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vestavia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.