Dominique Backus

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

5065 Issued in AL

Practice address

3507 Old Montgomery Hwy
Birmingham, AL 35209-5751

Phone

(205) 879-0557

NPI assigned

Apr 8, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Dominique Backus LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Birmingham, AL
  • NPI 1093816837
  NPD (past) Authorized official

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1689817546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 OLD MONTGOMERY HWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352095751",
            "telephone_number": "205-879-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 OLD MONTGOMERY HWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352095751",
            "telephone_number": "205-879-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKUS",
        "first_name": "DOMINIQUE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AL",
            "license": "5065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Paige Babin, MD
• Ryan M Babl, DPT
• Kimo Bachiashvili, M.D.
• Kurt Christopher Bachmann, MD
• Delphine Olivia Backay
• Jessica Bacon
• Bastien Henri Bacro-Duverger, MD
• John W Baddley, MD
• Lorelle W. Baddley, D.D.S.
• Crawford Glenn Badham, D.M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.