Individual provider Active NPI

Carole M. Emanuel, DDS

  • General Practice Dentistry
  • Lakewood, CO
National Provider Identifier
1164631644
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
202997 Issued in CO
Practice address
7373 West Jefferson Ave.
Suite #304
Lakewood, CO 80235
Phone
(303) 986-0090
Fax
(720) 379-6673
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11411 GA
General Practice Dentistry 1223G0001X 202997 CO Primary

Addresses

Primary practice location

7373 West Jefferson Ave.
Suite #304
Lakewood, CO 80235

Mailing address

7373 West Jefferson Ave.
Suite #304
Lakewood, CO 80235
Phone (303) 986-0090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161207002718 CO Order and Referring Only - DentistPractitioner - Dentist 7012297153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202997COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Dental Associates of Atlanta, P.C. General Practice PastSince Aug 28, 2021 Accepting new patients
Charles R. Arp, DDS, PC General Practice Past Accepting new patients

Organizations & group practices 2

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1164631644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 WEST JEFFERSON AVE.",
            "address_2": "SUITE #304",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80235",
            "telephone_number": "303-986-0090",
            "fax_number": "720-379-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 WEST JEFFERSON AVE.",
            "address_2": "SUITE #304",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80235",
            "telephone_number": "303-986-0090",
            "fax_number": "720-379-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMANUEL",
        "first_name": "CAROLE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "11411",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "202997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.