Charris Allen
Individual provider Active NPI General Practice Dentistry · Newark, DE
NPI 1073192563 · NPPES record last updated Jul 26, 2022
Key facts
- NPI
- 1073192563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0011521 (DE)
- Practice address
- 300 Biddle Ave Ste 204
Newark, DE 19702-3972 - Phone
- (302) 838-8306
- NPI assigned
- Apr 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210616002325 | DE | Order and Referring Only - Dentist |
5799185419 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0011521 | DE | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Brite Dental Care | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0011521 | DE | Yes |
Addresses
Primary practice location
300 Biddle Ave Ste 204
Newark, DE 19702-3972
Mailing address
501 W 14TH St
Wilmington, DE 19801-1013
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Newark |
Other providers in Newark, DE
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- Joy L Allen Coleman
- Ashleigh Allen
- Colleen L. Allen
- Dannielle Lynn Allen
- Donna M Allen
- Lakia Allen
- Allera Geriatric Services PC
All providers in Newark, DE · General Practice Dentistry in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.