Individual provider Active NPI

Elyse Katherine Dengler, DMD

  • Dentist
  • Birmingham, AL
National Provider Identifier
1972098911
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D0006617-C1 Issued in AL
Practice address
5720 1St Ave S
Birmingham, AL 35212-2522
Phone
(205) 380-9455
NPI assigned
Jun 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D0006617-C1 AL Primary

Addresses

Primary practice location

5720 1St Ave S
Birmingham, AL 35212-2522

Mailing address

5720 1St Ave S
Birmingham, AL 35212-2522
Phone (205) 380-9455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20180731003170 NC Order and Referring Only - DentistPractitioner - Dentist 2365790805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D0006617-C1ALMDDentist
11095NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1972098911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 1ST AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352122522",
            "telephone_number": "205-380-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 1ST AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352122522",
            "telephone_number": "205-380-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENGLER",
        "first_name": "ELYSE",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D0006617-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.