Kelvin Scott Whitaker, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AL4965 Issued in AL

Practice address

1215 13TH Ave SE
Decatur, AL 35601-4306

Phone

(256) 353-1481

NPI assigned

Oct 6, 2006

Last updated

Jul 9, 2007By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornerstone Dentistry of Decatur

  • General Practice Dentistry
  • Decatur, AL
  • NPI 1215024690
  NPD (past) Authorized official

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831286210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 13TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014306",
            "telephone_number": "256-353-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 13TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014306",
            "telephone_number": "256-353-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "KELVIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL4965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51514998 WHI",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Welden Ondocsin Dentistry LLC (Decatur Comprehensive Dentistry)
• Kimberly Jill Welden, DMD
• Pamela Deann Whaley, COTA/L
• Wheeler Emergency Group LLC
• Wheeler Physician Services LLC
• Lori Whitehead
• Whitfield Family Practice LLC
• Amber Johnson Whitfield, MD
• William Craig Whitley, M.D.
• Kami Elizabeth Whorton, CRNP

• General Practice Dentistry in Decatur, AL
• Providers in Decatur, 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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.