Organization Active NPI

Randle T. Carr, DDS, P.S.

  • General Practice Dentistry
  • Bellingham, WA
National Provider Identifier
1053326538
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008137 Issued in WA
Legal business name
RANDLE T. CARR, DDS, P.S.
Practice address
3400 Squalicum Pkwy
Suite 107
Bellingham, WA 98225-1933
Phone
(360) 734-9926
Fax
(360) 734-0855
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Authorized official

Name
Dr. Randle T Carr, DDS
Title
President
Phone
(360) 734-9926

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00008137 WA Primary

Addresses

Primary practice location

3400 Squalicum Pkwy
Suite 107
Bellingham, WA 98225-1933

Mailing address

3400 Squalicum Pkwy
Suite 107
Bellingham, WA 98225-1933
Phone (360) 734-9926

Other identifiers 2

IdentifierTypeStateIssuer
602-330-302OtherWAWA UBI NUMBER
5038815MedicaidWA

National Provider Directory

National Provider Directory

Locations

3400 Squalicum Pkwy
Ste 107
Bellingham, WA 98225
Phone (360) 734-9926

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1053326538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SQUALICUM PKWY",
            "address_2": "SUITE 107",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251933",
            "telephone_number": "360-734-9926",
            "fax_number": "360-734-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SQUALICUM PKWY",
            "address_2": "SUITE 107",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251933",
            "telephone_number": "360-734-9926",
            "fax_number": "360-734-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDLE T. CARR, DDS, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "RANDLE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-734-9926",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA UBI NUMBER",
            "identifier": "602-330-302",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5038815",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.