TODD L LACKEY (NPI# 1467557199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467557199 |
| Entity Type | Individual |
| Full Name | TODD L LACKEY |
| Credential | D.D.S. |
| Practice Address |
4001 Balmoral Dr Sw Huntsville AL 35801-6403 |
| Practice Telephone | 2565397447 |
| Practice Fax Number | 2565341233 |
| Mailing Telephone | 2565397447 |
| Mailing Fax Number | 2565341233 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
4855 | AL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BC/BS ALABAMA | 51092706 | 01 |
| Street Address |
4001 BALMORAL DR SW |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35801-6403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932151594 | Dean Corbly Brandon | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2006-05-16 |
| 1114309705 | Emily Anne Latta Grisham | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2015-06-19 |
| 1518154194 | Kevin Dwight Tesseneer | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2007-09-27 |
| 1851446595 | Alabama Pediatric Dental Associates and Orthodontics | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2007-01-24 |
| 1710053376 | Brent Marc Masterson | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2006-11-27 |
| 1821190687 | Paul Wayne Sproul | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2006-09-02 |
| 1407802168 | Richard Mason Butler Jr. | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422742 | Elena Mihaela Kruse | Nurse Practitioner | 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 | 2020-09-18 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1003472978 | Gina Marie Delgado | Nurse Practitioner | Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 | 2019-05-15 |
| 1366909863 | Lisa Starkey Suggs | Nurse Practitioner | 3500 Memorial Parkway S.w., Huntsville, AL 35801 | 2019-02-21 |
| 1902373277 | Kelly S Fisher LLC | Counselor | 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 | 2018-10-25 |
| 1073097911 | Brittani B Hamrick | Psychologist | 203 Eastside Sq Ste C9, Huntsville, AL 35801 | 2018-09-17 |
| 1548748312 | Jane O. Orton, Licsw, LLC | Social Worker | 120 Holmes Ave Ne, Huntsville, AL 35801 | 2018-08-02 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1366968398 | Bennett Brent Smith | Physician Assistant | 825 Adams St. Se, Huntsville, AL 35801 | 2017-08-22 |
| Find all providers in zip 35801 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346469244 | Whitney Owen Shelton | Dentist | 1105 Gleneagles Dr Sw, Huntsville, AL 35801-6405 | 2007-04-25 |
| 1730281692 | Michael David Brown | Dentist | 114 Bob Wallace Ave Sw, Huntsville, AL 35801-3823 | 2006-09-02 |
| 1417999152 | Brian A Beitel | Dentist | 580 Airport Rd Sw, Huntsville, AL 35802-1309 | 2006-06-10 |
| 1932151594 | Dean Corbly Brandon | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2006-05-16 |
| 1578561924 | Casey Rene Frazier | Dentist | 100 Medical Center Pkwy, Suite #700, Huntsville, TX 77340 | 2005-07-11 |
| 1821591561 | Beitel Pediatric Dentistry | Dentist | 580 Airport Rd Sw, Huntsville, AL 35802-1309 | 2018-03-08 |
| 1912021247 | Charles R Hall | Dentist | 1110 Meridian St N, Huntsville, AL 35801-4636 | 2007-03-19 |
| 1962526285 | Richard R Cannon | Dentist | 1110 Meridian St N, Huntsville, AL 35801-4636 | 2007-03-19 |
| 1851446595 | Alabama Pediatric Dental Associates and Orthodontics | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2007-01-24 |
| 1710053376 | Brent Marc Masterson | Dentist | 4001 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2006-11-27 |
| Find all providers in HUNTSVILLE | ||||
| City | HUNTSVILLE |
| Zip Code | 35801 |
Please comment or provide details below to improve the information on TODD L LACKEY.
| 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.