Individual provider Active NPI

Charles Thomas Carr, DDS

  • Dentist
  • Amarillo, TX
National Provider Identifier
1164523445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21576 Issued in TX
Practice address
7200 W 45TH Ave
Ste 5
Amarillo, TX 79109-5084
Phone
(806) 677-0202
Fax
(806) 677-0205
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21576 TX Primary

Addresses

Primary practice location

7200 W 45TH Ave
Ste 5
Amarillo, TX 79109-5084

Mailing address

7200 W 45TH Ave
Ste 5
Amarillo, TX 79109-5084
Phone (806) 677-0202

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
21576TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yellow City Smiles PLLC PastSince May 29, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164523445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 W 45TH AVE",
            "address_2": "STE 5",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791095084",
            "telephone_number": "806-677-0202",
            "fax_number": "806-677-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 W 45TH AVE",
            "address_2": "STE 5",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791095084",
            "telephone_number": "806-677-0202",
            "fax_number": "806-677-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "CHARLES",
        "middle_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "21576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.