Individual provider Active NPI

Annie Kristin Carberry, DDS

  • Dentist
  • Charlotte, NC
National Provider Identifier
1053731737
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9712 Issued in NC
Practice address
201 Providence Rd
Charlotte, NC 28207-1417
Phone
(704) 376-6470
Fax
(704) 496-2988
NPI assigned
Apr 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9712 NC Primary

Addresses

Primary practice location

201 Providence Rd
Charlotte, NC 28207-1417

Mailing address

201 Providence Rd
Charlotte, NC 28207-1417
Phone (704) 376-6470

Other practice location 1

358 Marine Pkwy
Suite 100
Redwood City, CA 94065-1010
Phone (650) 595-0106

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
9712NCMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Annie B Carberry DDS, PLLC Current Accepting new patients
Armstrong & Eshleman, PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053731737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PROVIDENCE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071417",
            "telephone_number": "704-376-6470",
            "fax_number": "704-496-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PROVIDENCE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071417",
            "telephone_number": "704-376-6470",
            "fax_number": "704-496-2988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "358 Marine Pkwy",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940651010",
            "country_code": "US",
            "telephone_number": "650-595-0106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBERRY",
        "first_name": "ANNIE",
        "middle_name": "KRISTIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.