Individual provider Active NPI

Daniel Carvel Deese, DMD

  • Dentist
  • Fairhope, AL
National Provider Identifier
1710098314
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5155 Issued in AL
Practice address
24370 US Hwy 98
Fairhope, AL 36532
Phone
(251) 990-0838
Fax
(251) 990-5552
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5155 AL Primary

Addresses

Primary practice location

24370 US Hwy 98
Fairhope, AL 36532

Mailing address

24370 US Hwy 98
Fairhope, AL 36532
Phone (251) 990-0838

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
I20160621001599 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648561753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5155ALMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710098314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24370 US HWY 98",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "36532",
            "telephone_number": "251-990-0838",
            "fax_number": "251-990-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24370 US HWY 98",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "36532",
            "telephone_number": "251-990-0838",
            "fax_number": "251-990-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEESE",
        "first_name": "DANIEL",
        "middle_name": "CARVEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.