Amanda Marie Carroll, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010413 Issued in AZ

Practice address

1305 E Butte Ave
Florence, AZ 85132-9221

Phone

(602) 380-5122

NPI assigned

Jul 8, 2019

Last updated

Apr 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Salt River Pima-Maricopa Indian Community

  dba Salt River Integrated Health Care

  • Community Health Clinic/Center
  • Scottsdale, AZ
  • NPI 1942668991

  Single Specialty, TX

  Medicare reassignment NPD
• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  Single Specialty, TX

  Medicare reassignment NPD
• Salt River Pima-Maricopa Indian Community

  dba Department of Health and Human Services

  • Community Health Clinic/Center
  • Scottsdale, AZ
  • NPI 1538583125
  NPD
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1023670338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 E BUTTE AVE",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851329221",
            "telephone_number": "309-299-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 E BUTTE AVE",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851329221",
            "telephone_number": "602-380-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiac Arrhythmia Institute LLC
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• Nikel Austelly Casimir, PA
• Cherishing Life LLC
• Child Development & Education, LLC
• Alice Clark

• General Practice Dentistry in Florence, AZ
• Providers in Florence, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.