DOMINIQUE BACKUS LLC (NPI# 1093816837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093816837 |
| Entity Type | Organization |
| Organization Name | DOMINIQUE BACKUS LLC |
| Other Organization Name | ORTHODONTIC ASSOCIATES PA |
| Practice Address |
3507 Old Montgomery Hwy Birmingham AL 35209 |
| Practice Telephone | 2058790557 |
| Practice Fax Number | 2058796611 |
| Mailing Telephone | 2058790557 |
| Mailing Fax Number | 2058796611 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DOMINIQUE VIDRINE BACKUS (ORTHODONTIST) |
| Authorized Official Telephone | 2058790557 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
5065 | AL | Dental Providers |
| Other Name | Type Code |
|---|---|
| Orthodontic Associates PA | Doing Business As Name - Organization |
| Street Address |
3507 OLD MONTGOMERY HWY |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689817546 | Dominique Backus | Dentist | 3507 Old Montgomery Hwy, Birmingham, AL 35209-5751 | 2009-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417573825 | William Bates | Dentist | 2826 Lakeshore Pkwy, Birmingham, AL 35211-5500 | 2020-06-22 |
| 1144873332 | James M Fraser II | Dentist | 2388 Cole St Ste 103, Birmingham, MI 48009-7009 | 2019-07-17 |
| 1619407657 | Priscila Arruda Denny | Dentist | 2029 Old Montgomery Hwy, Birmingham, AL 35244-1606 | 2017-06-13 |
| 1538549241 | Paige Dianna Whitt | Dentist | 406 Hollywood Blvd, Birmingham, AL 35209-2021 | 2015-06-08 |
| 1073908364 | Jamie Youngshin Kim | Dentist | 1919 7th Avenue South, Sdb 305, University of Alabama School of Dentistry, Birmingham, AL 35294 | 2015-04-02 |
| 1154688794 | Careybeth Hayes Rivers | Dentist | 4369 Ruth Rd, Birmingham, AL 35213-1609 | 2012-04-20 |
| 1336467406 | Nathan Warren Johnson | Dentist | 1451 River Walk Cir, Birmingham, AL 35216-6811 | 2010-05-13 |
| 1700021854 | Michael Brett Wood | Dentist | 5143 6th Ave S, Birmingham, AL 35212-3519 | 2008-12-03 |
| 1134301559 | Jon C. Moore | Dentist | 5100 Cyrus Cir, Birmingham, AL 35242-4630 | 2007-11-27 |
| 1093996332 | David M Sarver | Dentist | 1705 Vestavia Pkwy, Birmingham, AL 35216-3752 | 2007-11-15 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35209 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.