Active NPI
Thomas H. Cartledge III, D.D.S., M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Ormond Beach, FL
National Provider Identifier
1063661163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN0004071
- Practice address
- 106 N Old Kings Rd
Suite C
Ormond Beach, FL 32174-9505 - Phone
- (138) 672-4981
- Fax
- (386) 673-1476
- NPI assigned
- Sep 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN0004071 | FL | Primary |
Addresses
Primary practice location
106 N Old Kings Rd
Suite C
Ormond Beach, FL 32174-9505
Mailing address
106 N Old Kings Rd
Suite C
Ormond Beach, FL 32174-9505
Phone (138) 672-4981
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0740527 | Medicaid | FL |
Other names 1
- Dr. Brianne C. Desantis
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN0004071 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1063661163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 N OLD KINGS RD",
"address_2": "SUITE C",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321749505",
"telephone_number": "138-672-4981",
"fax_number": "386-673-1476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 N OLD KINGS RD",
"address_2": "SUITE C",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321749505",
"telephone_number": "138-672-4981",
"fax_number": "386-673-1476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTLEDGE",
"first_name": "THOMAS",
"middle_name": "H.",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DN0004071",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0740527",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BRIANNE",
"last_name": "DESANTIS",
"middle_name": "C.",
"prefix": "DR.",
"credential": "D.M.D., M.S.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.