Leroy Bertram Alford, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

008829 Issued in GA

Practice address

10 Legacy Way
Suite C
Adairsville, GA 30103-2461

Phone

(770) 773-7227

Fax

(706) 291-0684

NPI assigned

Apr 7, 2009

Last updated

Mar 3, 2010By the provider in NPPES

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

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

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1750524765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 106",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620106",
            "telephone_number": "770-773-7227",
            "fax_number": "706-291-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LEGACY WAY",
            "address_2": "SUITE C",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "301032461",
            "telephone_number": "770-773-7227",
            "fax_number": "706-291-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFORD",
        "first_name": "LEROY",
        "middle_name": "BERTRAM",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "008829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00186876B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Scott Abston, PTA
• Adairsville Drug Inc
• Adairsville Eye Associates LLC
• Adairsville Worx LLC (Adairsville Drug)
• Akasha Counseling LLC
• Allmon Chiropractic
• Patty Allmon, DC
• Tamela Baker
• Eric Glen Borstelmann, COTA/L
• Bradley and Brandy Neighborhood Pharmacy LLC (Bradley and Brandy Pharmacy)

• Periodontics in Adairsville, GA
• Providers in Adairsville, GA by specialty
• Periodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.