Active NPI
Charles Michael Bordenca, DMD
- Pediatric Dentistry
- Alabaster, AL
National Provider Identifier
1871601435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2840
- Practice address
- 219 1St Street N
Alabaster, AL 35007 - Phone
- (205) 664-2130
- Fax
- (205) 664-0287
- NPI assigned
- Aug 25, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2840 | AL | Primary |
Addresses
Primary practice location
219 1St Street N
Alabaster, AL 35007
Mailing address
PO Box 737
Alabaster, AL 35007-2048
Phone (205) 664-2130
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 |
|---|---|---|---|
| 2840 | AL | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lauri M. Williams, DMD, PC | Pediatric Dentistry | Past | Accepting new patients |
| Rock Dental Alabama PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatric Dentistry
- Alabaster, AL
- NPI 1780794214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871601435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 737",
"city": "ALABASTER",
"state": "AL",
"postal_code": "350072048",
"telephone_number": "205-664-2130",
"fax_number": "205-664-0287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 1ST STREET N",
"city": "ALABASTER",
"state": "AL",
"postal_code": "35007",
"telephone_number": "205-664-2130",
"fax_number": "205-664-0287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDENCA",
"first_name": "CHARLES",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AL",
"license": "2840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alabaster, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.