Individual provider Active NPI

Brandon Snell, D.M.D.

  • General Practice Dentistry
  • Dothan, AL
National Provider Identifier
1821379140
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5856 Issued in AL
Practice address
107 Professional LN
Dothan, AL 36303-3875
Phone
(334) 792-5711
Fax
(334) 678-8157
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5856 AL Primary

Addresses

Primary practice location

107 Professional LN
Dothan, AL 36303-3875

Mailing address

107 Professional LN
Dothan, AL 36303-3875
Phone (334) 792-5711

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
I20250507002407 AL Order and Referring Only - DentistPractitioner - Dentist 9739606351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5856ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dental Care of Dothan, PC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1821379140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PROFESSIONAL LN",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033875",
            "telephone_number": "334-792-5711",
            "fax_number": "334-678-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 PROFESSIONAL LN",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033875",
            "telephone_number": "334-792-5711",
            "fax_number": "334-678-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNELL",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.