Gary Wayne Backer, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3375 Issued in AL

Practice address

4004 Balmoral Dr SW
Huntsville, AL 35801-6402

Phone

(256) 883-0030

Fax

(256) 883-0235

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902017049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016402",
            "telephone_number": "256-883-0030",
            "fax_number": "256-883-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016402",
            "telephone_number": "256-883-0030",
            "fax_number": "256-883-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKER",
        "first_name": "GARY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Babin, LPN
• Ashlynne Goodloe Bachman, PT, DPT
• Melissa Kay Bachman, PA-C
• John T. Bachmann, D.M.D.
• Back Pain Relief Chiropractic LLC
• Sujatha Baddam
• Jennifer Hope Baggenstoss, PA-C
• Alan Stephen Baggett, M.D.
• Dane W Bagley, O.D.
• Sam Bagley, M.D.

• General Practice Dentistry in Huntsville, AL
• Providers in Huntsville, 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 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.

Verify at the official NPI Registry.