Andrea Cibulski, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AL5411 Issued in AL

Practice address

402A Cogswell Ave
Pell City, AL 35125-2446

Phone

(205) 338-2970

Fax

(205) 338-7175

NPI assigned

Sep 20, 2007

Last updated

Sep 20, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eden Family Dentistry

  • Dentist
  • Pell City, AL
  • NPI 1083023089
  NPD (past)

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1518153816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402A COGSWELL AVE",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351252446",
            "telephone_number": "205-338-2970",
            "fax_number": "205-338-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402A COGSWELL AVE",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351252446",
            "telephone_number": "205-338-2970",
            "fax_number": "205-338-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIBULSKI",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL5411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "04630",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "04630",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexa Lee Carter
• Anna E Carwie
• Victor Cheng, DMD
• Claire Rae Chesnut
• Christopher M Rothman, DDS, LLC
• City of Pell City
• Sarah C. Cleghern, OD
• Clinical Urology Associates, P.C.
• Kimberli Clinkscales, CRNP
• Douglas Edwin Cole, PT

• 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 Sep 20, 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.

Verify at the official NPI Registry.