Individual provider Active NPI

Carlos Parra Carrasquer, DDS

  • Periodontics
  • Dallas, TX
National Provider Identifier
1053660050
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
31527 Issued in TX
Practice address
3302 Gaston Ave
Dallas, TX 75246-2013
Phone
(214) 828-8369
NPI assigned
Sep 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 31527 TX Primary

Addresses

Primary practice location

3302 Gaston Ave
Dallas, TX 75246-2013

Mailing address

2627 Live Oak St. Apt 15129
Dallas, TX 75204
Phone (617) 971-6788

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31527TXMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1053660050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 LIVE OAK ST. APT 15129",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75204",
            "telephone_number": "617-971-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462013",
            "telephone_number": "214-828-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRA CARRASQUER",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "31527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; 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.