Individual provider Active NPI

Carter Craig Melendez-Christensen, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Lexington, KY
National Provider Identifier
1366094708
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
1209 Issued in KY
Practice address
3159 Beaumont Centre Cir Ste 110
Lexington, KY 40513-1968
Phone
(859) 278-9376
Fax
(859) 276-0260
NPI assigned
Jul 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 1209 KY Primary

Addresses

Primary practice location

3159 Beaumont Centre Cir Ste 110
Lexington, KY 40513-1968

Mailing address

3159 Beaumont Centre Cir Ste 110
Lexington, KY 40513-1968
Phone (859) 278-9376

Other practice location 1

611 W Park St
Urbana, IL 61801-2529
Phone (217) 383-6637

Other practice location 2

2424 Sir Barton Way Ste 375
Lexington, KY 40509-2747
Phone (859) 207-4790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2024 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1209KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Center for Oral & Maxillofacial Surgery Past Accepting new patients
Kentucky Center for Oral & Maxillofacial Surgery PSC Oral and Maxillofacial Surgery Past Accepting new patients
Kentucky Center for Oral & Maxillofacial Surgery Past Accepting new patients
Kentucky Center for Oral & Maxillofacial Surgery Past Accepting new patients
Kentucky Center for Oral & Maxillofacial Surgery PSC Oral and Maxillofacial Surgery Past Accepting new patients
Kentucky Center for Oral & Maxillofacial Surgery PSC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 6

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1366094708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3159 BEAUMONT CENTRE CIR STE 110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131968",
            "telephone_number": "859-278-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3159 BEAUMONT CENTRE CIR STE 110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131968",
            "telephone_number": "859-278-9376",
            "fax_number": "859-276-0260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 W Park St",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "IL",
            "postal_code": "618012529",
            "country_code": "US",
            "telephone_number": "217-383-6637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2424 Sir Barton Way Ste 375",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092747",
            "country_code": "US",
            "telephone_number": "859-207-4790",
            "fax_number": "859-340-1928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELENDEZ-CHRISTENSEN",
        "first_name": "CARTER",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "1209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.