Paul Hoke Fellers III, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

5292 Issued in AL

Practice address

24208 US Highway 98
Suite C
Fairhope, AL 36532-3466

Phone

(251) 928-3030

Fax

(251) 928-2455

NPI assigned

Oct 11, 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.

• Dr. Trey'S Children'S Dentistry

  • Pediatric Dentistry
  • Fairhope, AL
  • NPI 1730459538
  NPD (past) Authorized official

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1679761902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N SECTION STREET",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "36532",
            "telephone_number": "251-928-3030",
            "fax_number": "251-928-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24208 US HIGHWAY 98",
            "address_2": "SUITE C",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323466",
            "telephone_number": "251-928-3030",
            "fax_number": "251-928-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLERS",
        "first_name": "PAUL",
        "middle_name": "HOKE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "5292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009990685",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family First Caregivers
• Family Medicine Specialist LLC
• Family Practice Associates of Montrose, PA
• Angel Farrow, MSPT
• Robert F Favret Jr., M.D.
• Paul Hoke Fellers Jr., M.D.
• Sean Q. Fisk, P.A.
• Susie Fitzharris, MD
• Audrey Elizabeth Flower, DO
• Focal Point Optometric Services, LLC

• Pediatric Dentistry in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Pediatric Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.