Individual provider Active NPI

Robert Corey

  • General Practice Dentistry
  • Barksdale Afb, LA
National Provider Identifier
1528797354
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-0007029-C1 Issued in AL
Practice address
1067 Twining Dr
Barksdale Afb, LA 71110-2486
Phone
(318) 456-6718
NPI assigned
Jun 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X AL
General Practice Dentistry 1223G0001X D-0007029-C1 AL Primary

Addresses

Primary practice location

1067 Twining Dr
Barksdale Afb, LA 71110-2486

Mailing address

1067 Twining Dr
Barksdale Afb, LA 71110-2486
Phone (318) 456-6718

Other practice location 1

81DS/SGDR
Apo, AA 39534
Phone (205) 516-7796

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

LicenseStateTypeSpecialty
D-0007029-C1ALMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1528797354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 TWINING DR",
            "city": "BARKSDALE AFB",
            "state": "LA",
            "postal_code": "711102486",
            "telephone_number": "318-456-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 TWINING DR",
            "city": "BARKSDALE AFB",
            "state": "LA",
            "postal_code": "711102486",
            "telephone_number": "318-456-6718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81DS/SGDR",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AA",
            "postal_code": "39534",
            "country_code": "US",
            "telephone_number": "205-516-7796",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "COREY",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0007029-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barksdale Afb, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.