1917 Dental Clinic
NPI 1093452633ActiveOrganization· Dentist· Birmingham, AL
Dentist in Birmingham, Alabama, registered in NPPES in May 2022, part of University of Alabama at Birmingham. The authorized official on file is Jacquiselyn Story, Business Office Director.
Overview
| NPI | 1093452633 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | University of Alabama at Birmingham |
| NPI issued | May 16, 2022 |
| Last updated in NPPES | May 17, 2022 |
| Certified by provider | May 17, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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