Individual provider Active NPI

Carissima Ellen Aloe, D.D.S.

  • General Practice Dentistry
  • Ludington, MI
National Provider Identifier
1265450563
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901013586 Issued in MI
Practice address
102 S Washington Ave
Ludington, MI 49431-2283
Phone
(231) 843-2751
Fax
(231) 845-8336
NPI assigned
Jul 17, 2006
Sex
Female
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
General Practice Dentistry 1223G0001X 2901013586 MI Primary

Addresses

Primary practice location

102 S Washington Ave
Ludington, MI 49431-2283

Mailing address

102 S Washington Ave
Ludington, MI 49431-2283
Phone (231) 843-2751

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150430002278 MI Order and Referring Only - DentistPractitioner - Dentist 8628397338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901013586MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265450563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S WASHINGTON AVE",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312283",
            "telephone_number": "231-843-2751",
            "fax_number": "231-845-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S WASHINGTON AVE",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312283",
            "telephone_number": "231-843-2751",
            "fax_number": "231-845-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALOE",
        "first_name": "CARISSIMA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.