1487030086 NPI number — DAVID ALLEMAN DMD

Table of content: DAVID ALLEMAN DMD (NPI 1487030086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487030086 NPI number — DAVID ALLEMAN DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLEMAN
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487030086
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ATTN: CREDENTIALS OFFICE FT HUACHUCA
Provider Second Line Business Mailing Address:
USA DENTAC BLDG 51005 WINANS RILEY BARRACKS
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AA
Provider Business Mailing Address Postal Code:
85613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIT 15652
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205-5652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
11-822-7917
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  9434429-9922 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1487030086 . This is a "ARMY" identifier . This identifiers is of the category "OTHER".




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