Active NPI
Carl Martin Honerlaw, DDS
- General Practice Dentistry
- Port Orange, FL
National Provider Identifier
1366655466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- AH2577053
- Practice address
- 3943 S Nova Rd
Port Orange, FL 32127-4910 - Phone
- (386) 761-9440
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | AH2577053 | FL | Primary |
Addresses
Primary practice location
3943 S Nova Rd
Port Orange, FL 32127-4910
Mailing address
1 Sunny Pines Cir
Daytona Beach, FL 32118-5218
Phone (138) 625-5404
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AH2577053 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366655466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SUNNY PINES CIR",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321185218",
"telephone_number": "138-625-5404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3943 S NOVA RD",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321274910",
"telephone_number": "386-761-9440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HONERLAW",
"first_name": "CARL",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "AH2577053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.