Active NPI
Mark Landis Carr, DDS
- General Practice Dentistry
- Cameron, MO
National Provider Identifier
1053590919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 14415
- Practice address
- 312 N Walnut
Cameron, MO 64429-1825 - Phone
- (816) 632-5812
- Fax
- (816) 632-8879
- NPI assigned
- Oct 29, 2007
- Last updated
- Nov 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 14415 | MO | Primary |
Addresses
Primary practice location
312 N Walnut
Cameron, MO 64429-1825
Mailing address
312 N Walnut
Cameron, MO 64429-1825
Phone (816) 632-5812
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14415 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1053590919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 N WALNUT",
"city": "CAMERON",
"state": "MO",
"postal_code": "644291825",
"telephone_number": "816-632-5812",
"fax_number": "816-632-8879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 N WALNUT",
"city": "CAMERON",
"state": "MO",
"postal_code": "644291825",
"telephone_number": "816-632-5812",
"fax_number": "816-632-8879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "MARK",
"middle_name": "LANDIS",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-29",
"last_updated": "2007-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "14415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cameron, MO
- Cameron Regional Medical Center, Inc. (Swing Bed Services)
- Cameron Regional Medical Center, Inc.
- Cameron Regional Medical Center, Inc. (Behaviorial Health Unit)
- Cristi Campbell, FNP
- Richard D Campbell, ANP
- Charles E Chatfield, NP-C
- Clay Poplin LCSW, LLC
- Jennifer Larae Clemons, COTA/L
- Clinco Sheltered Industries, Inc.
- Marci Rhea Cline, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.