Individual provider Active NPI

Gregory Alan Carman, DMD

  • Endodontics
  • Lexington, KY
National Provider Identifier
1063586261
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7122 Issued in KY
Practice address
620 Perimeter Dr
Suite 203
Lexington, KY 40517-4125
Phone
(859) 268-7668
Fax
(859) 972-0772
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7122 KY
Endodontics 1223E0200X 7122 KY Primary

Addresses

Primary practice location

620 Perimeter Dr
Suite 203
Lexington, KY 40517-4125

Mailing address

620 Perimeter Dr
Suite 203
Lexington, KY 40517-4125
Phone (859) 268-7668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20140915001495 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7719106368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7122KYMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1063586261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 PERIMETER DR",
            "address_2": "SUITE 203",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174125",
            "telephone_number": "859-268-7668",
            "fax_number": "859-972-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PERIMETER DR",
            "address_2": "SUITE 203",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174125",
            "telephone_number": "859-268-7668",
            "fax_number": "859-972-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMAN",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "7122",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KY",
            "license": "7122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.