Robert W Harradine, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

5077 Issued in AL

Practice address

2121 14TH Ave S
Birmingham, AL 35205-3901

Phone

(205) 933-1291

Fax

(205) 930-9029

NPI assigned

Apr 13, 2007

Sex

Male

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 1

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 and National Provider Directory roles.

• Complete Dental Care, P.C.

  • Prosthodontics
  • Birmingham, AL
  • NPI 1801915236
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609090042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 14TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053901",
            "telephone_number": "205-933-1291",
            "fax_number": "205-930-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 14TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053901",
            "telephone_number": "205-933-1291",
            "fax_number": "205-930-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRADINE",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "AL",
            "license": "5077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA DENTAL LICENSE",
            "identifier": "5077",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Harper
• Raeanna Cooner Harper, NP
• Scott Harper, MD
• Sharon Elizabeth Harper, LPC
• Kimberly Reed Harradine, D.M.D.
• Andrew Harrell, CRNA
• Daphne Harrell
• Jonathan Harrell
• Lindy E Harrell, MD
• Thomas G Harrell, MD

• Prosthodontics in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Prosthodontics in Alabama

• 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.

Verify at the official NPI Registry.