Active NPI
Robert E Sanderson, D.M.D.
- General Practice Dentistry
- Hoover, AL
National Provider Identifier
1780649053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4019
- Practice address
- 2112 Lynngate Dr
Hoover, AL 35216-5244 - Phone
- (205) 822-0155
- Fax
- (205) 978-5514
- NPI assigned
- Apr 19, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4019 | AL | Primary |
Addresses
Primary practice location
2112 Lynngate Dr
Hoover, AL 35216-5244
Mailing address
2112 Lynngate Dr
Hoover, AL 35216-5244
Phone (205) 822-0155
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 744843 | Other | PA | UNITED CONCORDIA |
| 90712 | Other | AL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4019 | AL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vestavia Dental Group P C | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Birmingham, AL
- NPI 1629456488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1780649053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2112 LYNNGATE DR",
"city": "HOOVER",
"state": "AL",
"postal_code": "352165244",
"telephone_number": "205-822-0155",
"fax_number": "205-978-5514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 LYNNGATE DR",
"city": "HOOVER",
"state": "AL",
"postal_code": "352165244",
"telephone_number": "205-822-0155",
"fax_number": "205-978-5514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERSON",
"first_name": "ROBERT",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "4019",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "744843",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "90712",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hoover, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.