Individual provider Active NPI

Collena Robertson, DMD

  • General Practice Dentistry
  • Anniston, AL
National Provider Identifier
1659933190
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D.0006643-C1 Issued in AL
Practice address
1316 Noble St
Anniston, AL 36201-4643
Phone
(256) 492-0131
Fax
(256) 235-2019
NPI assigned
Jul 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0006643-C1 AL
General Practice Dentistry 1223G0001X D.0006643-C1 AL Primary

Addresses

Primary practice location

1316 Noble St
Anniston, AL 36201-4643

Mailing address

173 Lenox Dr
Birmingham, AL 35242-5246
Phone (704) 249-7657

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
I20200630003514 AL Practitioner - Dentist 0547599391 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0006643-C1ALMDGeneral Practice Dentistry
D.0006643-C1ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Whatley Health Services, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Whatley Health Services Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

2731 Ml King Jr Blvd
Tuscaloosa, AL 35401
Phone (205) 349-3250

Interoperability endpoints

  • Direct secure messaging: crobertson599804@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1659933190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 LENOX DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425246",
            "telephone_number": "704-249-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 NOBLE ST",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362014643",
            "telephone_number": "256-492-0131",
            "fax_number": "256-235-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "COLLENA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "0006643-C1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D.0006643-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

Verify at the official NPI Registry.