Elaine Gissendaner, D.M.D.
Individual provider Active NPI General Practice Dentistry · Talladega, AL
NPI 1962591099 · NPPES record last updated Aug 12, 2009
Key facts
- NPI
- 1962591099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4569 (AL)
- Practice address
- 129 North St E
Talladega, AL 35160-2188 - Phone
- (256) 362-6861
- Fax
- (256) 362-0932
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4569 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gissendaner Family Dentistry | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4569 | AL | Yes |
Addresses
Primary practice location
129 North St E
Talladega, AL 35160-2188
Mailing address
129 North St E
Talladega, AL 35160-2188
Phone (256) 362-6861
Other providers in Talladega, AL
- Heather Foster
- Shalonda D Gaddis
- Gadsden Limb & Brace, Inc.
- Rosanne Gallahar
- Gissendaner Family Dentistry
- Darlene Gooden
- Demaris Dorough Greene
- Greystone Neurology and Pain Centers, Inc.
- Craig Steven Gross
- Jerry Nolan Gurley
All providers in Talladega, AL · General Practice Dentistry in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.