Individual provider Active NPI

Philip B Tregoning, D.M.D.

  • General Practice Dentistry
  • Athens, AL
National Provider Identifier
1619057254
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4609 Issued in AL
Practice address
721 W Market St
Ste a
Athens, AL 35611-2456
Phone
(256) 232-3415
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 4609 AL Primary

Addresses

Primary practice location

721 W Market St
Ste a
Athens, AL 35611-2456

Mailing address

721 W Market St
Ste a
Athens, AL 35611-2456
Phone (256) 232-3415

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
I20150609001621 AL Order and Referring Only - DentistPractitioner - Dentist 0648479410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4609ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Dental Services General Practice Current Accepting new patients
Vibe Dental Group Al, LLC General Practice Current Accepting new patients

Locations

721 W Market St
Ste A
Athens, AL 35611
Phone (256) 232-3415

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1619057254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W MARKET ST",
            "address_2": "STE A",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112456",
            "telephone_number": "256-232-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W MARKET ST",
            "address_2": "STE A",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112456",
            "telephone_number": "256-232-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREGONING",
        "first_name": "PHILIP",
        "middle_name": "B",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, AL

Sources for this page

Verify at the official NPI Registry.