David Joseph Carbonell, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901020835 Issued in MI

Practice address

9500 Red Arrow Hwy
Bridgman, MI 49106-9593

Phone

(269) 465-3001

NPI assigned

Jun 3, 2014

Last updated

Jun 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Bucks Treasure PLLC

  dba Lighthouse Dental Group

  • Dentist
  • Bridgman, MI
  • NPI 1528290889
  NPD (past)

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1205249786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491060748",
            "telephone_number": "269-465-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 RED ARROW HWY",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069593",
            "telephone_number": "269-465-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONELL",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgman Care Operating, LLC (West Woods of Bridgman)
• Bridgman Chiropractors. P.C.
• Bridgman Psychological Services
• Bucks Treasure PLLC (Lighthouse Dental Group)
• Karen Burgard, NBC-HWC
• Shelly J Carter
• Lisa J Christy, D.D.S.
• Destiny Cole
• Country Manor Care Center
• Dockerty Health Care Services Inc (Woodland Terrace)

• Dentist in Bridgman, MI
• Providers in Bridgman, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.