Carla Marie Maxwell

Primary specialty

DentistTaxonomy code 122300000X

License

2901018110 Issued in MI

Practice address

5958 Canton Center Rd
Ste 400 Crest Expressions Dental Centers
Bloomfield Hills, MI 48304

Phone

(234) 451-9570

Fax

(734) 451-9574

NPI assigned

Apr 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1073785754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E LONG LAKE",
            "address_2": "STE 311 CREST EXPRESSIONS DENTAL CENTERS",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48304",
            "telephone_number": "248-203-1119",
            "fax_number": "248-723-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5958 CANTON CENTER RD",
            "address_2": "STE 400 CREST EXPRESSIONS DENTAL CENTERS",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48304",
            "telephone_number": "234-451-9570",
            "fax_number": "734-451-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "CARLA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Joseph Matway, M.D.
• Leslie Maunz, M.A.,C.C.C.-SLP
• Maureen a Kelly MD PLLC
• Cynthia Maurer, MPT
• Maximum Care Services LLC
• Timothy Arthur Mayer, D.D.S.
• Glen David Maylath, D.D.S.
• Christina Louise Mayo, PHD,LLP
• Shaleene Mayo
• Daniel Joseph McAleer, D.C.

• Dentist in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.

Verify at the official NPI Registry.