Matthew David Carlisle, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

34 Issued in AR

Practice address

1225 Breckenridge Dr
Suite #210
Little Rock, AR 72205-1558

Phone

(501) 225-4644

Fax

(501) 225-4102

NPI assigned

Oct 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1356538656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 BRECKENRIDGE DR",
            "address_2": "SUITE #210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051558",
            "telephone_number": "501-225-4644",
            "fax_number": "501-225-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 BRECKENRIDGE DR",
            "address_2": "SUITE #210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051558",
            "telephone_number": "501-225-4644",
            "fax_number": "501-225-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3613",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AR",
            "license": "34",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Cariker, MD
• Jillian Carlan, LCSW
• Scott W.F. Carle, M.D.
• Christopher Charles Carlin, CRNA
• Cameron Ray Carlisle, MS, CCC-SLP
• Charlotte A Carlson, LPC
• Carlton H. Burge, P.a
• Courtney Leigh Carmack, D.C.
• Debra Carman
• Fatimaah Salaam Carmichael

• Periodontics in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Periodontics in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.