Individual provider Active NPI

William Brett Whitaker, DMD

  • General Practice Dentistry
  • Tuscaloosa, AL
National Provider Identifier
1902333800
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6409-C1 Issued in AL
Practice address
204 McFarland Cir N
Tuscaloosa, AL 35406-1800
Phone
(205) 242-4120
NPI assigned
May 23, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6409-C1 AL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

204 McFarland Cir N
Tuscaloosa, AL 35406-1800

Mailing address

230 E 10TH St Ste 106
Anniston, AL 36207-5771
Phone (205) 242-4120

Other practice location 1

1141 Jasper Dennis Rd
Clanton, AL 35045-3783
Phone (205) 312-0001

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
I20190909004079 AL Practitioner - Dentist 5890050108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6409-C1ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cahaba Medical Care Foundation CurrentSince Jul 1, 2019 Accepting new patients
Cahaba Medical Care Foundation CurrentSince Jul 1, 2019 Accepting new patients
Advantage Dental Oral Health and Vision Center of Alabama, P.C. Past Accepting new patients
Advantage Dental Oral Health and Vision Center of Alabama, P.C. Past Accepting new patients

Locations

195 Hospital Dr
Centreville, AL 35042
Phone (205) 225-7455

405 Belcher St
Centreville, AL 35042
Phone (205) 926-4694

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902333800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 10TH ST STE 106",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075771",
            "telephone_number": "205-242-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MCFARLAND CIR N",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354061800",
            "telephone_number": "205-242-4120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1141 Jasper Dennis Rd",
            "address_purpose": "LOCATION",
            "city": "Clanton",
            "state": "AL",
            "postal_code": "350453783",
            "country_code": "US",
            "telephone_number": "205-312-0001",
            "fax_number": "205-312-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "WILLIAM",
        "middle_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6409-C1",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.