Gary Robin Pruitt Jr., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4659 Issued in AL

Practice address

2816 Columbiana Rd
Vestavia, AL 35216-2518

Phone

(205) 823-3223

Fax

(205) 823-8419

NPI assigned

Oct 18, 2006

Sex

Male

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

Enrolled in GA

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

Medicare enrollment (NPD)

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.

• Magic City Dentistry, PC

  • Dental Clinic/Center
  • Birmingham, AL
  • NPI 1790275840
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1730260308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 COLUMBIANA RD",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352162518",
            "telephone_number": "205-823-3223",
            "fax_number": "205-823-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 COLUMBIANA RD",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352162518",
            "telephone_number": "205-823-3223",
            "fax_number": "205-823-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "GARY",
        "middle_name": "ROBIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Spine, LLC
• Mallory Lee Pritchard, M.S., OTR/L
• Erin Pritchett, CRNA
• Laura Sheedy Promer, MS
• Matthew Prosch
• Publix Alabama LLC
• Purvis Dentistry, PC
• Flynt Gilbert Purvis, D.M.D.
• Puzzle Piece LLC
• R.David Roden, Jr.,DMD, MD, PC

• General Practice Dentistry in Vestavia, AL
• Providers in Vestavia, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.