Carol J McCutcheon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31952 Issued in CA

Practice address

166 W Campbell Ave
Campbell, CA 95008-1029

Phone

(408) 379-0851

Fax

(408) 378-7515

NPI assigned

Jan 15, 2007

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164573457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 W CAMPBELL AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081029",
            "telephone_number": "408-379-0851",
            "fax_number": "408-378-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 W CAMPBELL AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081029",
            "telephone_number": "408-379-0851",
            "fax_number": "408-378-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUTCHEON",
        "first_name": "CAROL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MB Photomedicine
• Sia Ndomanya Mbawa
• Julie Goehring McAfee, MA, CCC-SLP
• Kimberly Jane McCord
• Caitlin Mae McCuiston, B.A.
• Judith McFarland, MFT
• Kelly Ann McGrath, LVN
• Jovana McGraw
• Sean McGregor
• D. Katherine McKee, LMFT

• All providers in Campbell, CA
• General Practice Dentistry in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.