Individual provider Active NPI

Mark S Summerford, DMD

  • General Practice Dentistry
  • Auburn, AL
National Provider Identifier
1972684504
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5477 Issued in AL
Practice address
792 N Dean Rd
Auburn, AL 36830-4300
Phone
(334) 821-8755
Fax
(334) 821-9526
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5477 AL Primary

Addresses

Primary practice location

792 N Dean Rd
Auburn, AL 36830-4300

Mailing address

792 N Dean Rd
Auburn, AL 36830-4300
Phone (334) 821-8755

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
I20150722006427 AL Order and Referring Only - DentistPractitioner - Dentist 2062725856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5477ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Central Park Dental Care PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972684504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 N DEAN RD",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368304300",
            "telephone_number": "334-821-8755",
            "fax_number": "334-821-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 N DEAN RD",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368304300",
            "telephone_number": "334-821-8755",
            "fax_number": "334-821-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERFORD",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

Verify at the official NPI Registry.