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HOLTON DEATHERAGE
NPI 1417534116
Dentist in Birmingham, AL

Active since March 27, 2021PECOS Enrolled
1919 7TH AVE S, BIRMINGHAM, AL 35233(205) 934-4507 Get Directions Write a Review

NPPES record last updated: November 11, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 11, 2022, Mar 27, 2021 (2 updates tracked since 2021).

About Holton Deatherage NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLTON DEATHERAGE (NPI 1417534116) is an individual dentist in Birmingham, Alabama, licensed in Alabama (D-0007102-C1) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417534116
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameHOLTON DEATHERAGE
Location Address1919 7TH AVE SBirmingham, AL 35233-2005
Mailing Address1919 7th Ave SBirmingham, AL 35233-2005
Phone(205) 934-4507
Sole ProprietorNo
Enumeration DateMarch 27, 2021
Last NPPES UpdateNovember 11, 20222 updates tracked since enumeration
NPPES CertifiedNovember 11, 2022
✔ NPI 1417534116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in AL · D-0007102-C1
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1919 7TH AVE S, Birmingham, AL 35233
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holton Deatherage is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35233 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RYAN CHASE SEELEY DMD
Dentist
1919 7TH AVE S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4507
DR. ALEXANDRIA BRITTANEY BROWN
Dentist (General Practice)
1919 7TH AVE S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-3387
SOOMIN CHO
Student in an Organized Health Care Education/Training Program
1919 7TH AVE S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-3387
PAYTON LEWIS
Student in an Organized Health Care Education/Training Program
1919 7TH AVE S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-3387
SARAH CATHERINE LLOYD
Student in an Organized Health Care Education/Training Program
1919 7TH AVE S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-3000
DR. ERIC M. BLASINGAME DDS, MS
Dentist (Periodontics)
1919 7TH AVE S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4551
ETHAN LIAM PAGE BRENNA
Student in an Organized Health Care Education/Training Program
1919 7TH AVE S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-3387
SAMUEL MCMURRY
Student in an Organized Health Care Education/Training Program
1919 7TH AVE S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-3387

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holton Deatherage's NPI number?

The NPI number for Holton Deatherage is 1417534116. It was assigned to this individual provider in the NPPES registry on March 27, 2021.

Where is Holton Deatherage located?

Holton Deatherage practices at 1919 7th Ave S, Birmingham, AL 35233. The listed phone number is (205) 934-4507.

What is Holton Deatherage's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Holton Deatherage enrolled in Medicare?

Yes. Holton Deatherage is registered in the Medicare PECOS enrollment system.

What insurance does Holton Deatherage accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 9 other insurers list Holton Deatherage as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Holton Deatherage was last updated on November 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.