Individual provider Active NPI

Stephen Patrick McCulloch, D.M.D.

  • General Practice Dentistry
  • Wetumpka, AL
National Provider Identifier
1689783516
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5444 Issued in AL
Practice address
1194 Holtville Rd
Wetumpka, AL 36092-1103
Phone
(334) 567-7232
Fax
(334) 567-7291
NPI assigned
Aug 30, 2006
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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 5444 AL Primary

Addresses

Primary practice location

1194 Holtville Rd
Wetumpka, AL 36092-1103

Mailing address

1194 Holtville Rd
Wetumpka, AL 36092-1103
Phone (334) 567-7232

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160404000360 AL Order and Referring Only - Other (Non-Physician) 0143527317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5444ALMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1689783516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1194 HOLTVILLE RD",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360921103",
            "telephone_number": "334-567-7232",
            "fax_number": "334-567-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1194 HOLTVILLE RD",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360921103",
            "telephone_number": "334-567-7232",
            "fax_number": "334-567-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "STEPHEN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wetumpka, AL

Sources for this page

Verify at the official NPI Registry.