Individual provider Active NPI

Alan Lyvoid McAndrews, D.M.D.

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1518978790
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AL4585 Issued in AL
Practice address
4702 Misty Ridge Cir
Birmingham, AL 35235
Phone
(205) 769-6238
Fax
(205) 769-6245
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X AL4585 AL Primary

Addresses

Primary practice location

4702 Misty Ridge Cir
Birmingham, AL 35235

Mailing address

4702 Misty Ridge Circle
Birmingham, AL 35235
Phone (205) 769-6238

Other identifiers 1

IdentifierTypeStateIssuer
51092594OtherALBC/BS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160920000979 AL Order and Referring Only - DentistPractitioner - Dentist 3971890930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AL4585ALMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1518978790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 MISTY RIDGE CIRCLE",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35235",
            "telephone_number": "205-769-6238",
            "fax_number": "205-769-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 MISTY RIDGE CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35235",
            "telephone_number": "205-769-6238",
            "fax_number": "205-769-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCANDREWS",
        "first_name": "ALAN",
        "middle_name": "LYVOID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL4585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "51092594",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.