Raven-Deneice Grant Carouthers, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35602 Issued in TX

Practice address

820 S Damen Ave
Chicago, IL 60612-3728

Phone

(713) 574-0787

NPI assigned

Jul 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

Practice roles

Locations

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.

• Asian American Health Coalition of the Greater Houston Area

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1699966754
  Medicare reassignment NPD
• Harris County Hospital District

  • Family Medicine Physician
  • Houston, TX
  • NPI 1356428460

  General Practice

  Medicare reassignment NPD
• Asian American Health Coalition of the Greater Houston Area

  • Pharmacy
  • Houston, TX
  • NPI 1174236632
  NPD
• Asian American Health Coalition of the Greater Houston Area

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1972239341
  NPD
• Harris County Hospital District

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1205900370
  NPD
• Harris County Hospital District

  • General Practice Dentistry
  • Houston, TX
  • NPI 1538833231
  NPD

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1386296259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE STE 1390",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036036",
            "telephone_number": "713-574-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "713-574-0787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2112 Aldine Meadows Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770323102",
            "country_code": "US",
            "telephone_number": "713-773-0803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAROUTHERS",
        "first_name": "RAVEN-DENEICE",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032541",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn M Campbell PC
• Katherine Elizabeth Carome
• Elaina Caron, M.S CCC-SLP
• Elzbieta Marlena Carothers, APRN, CNP
• Shawanda Carothers, RDH
• Frazer C Carpenter, DPT
• Jennifer Lynn Carpenter, APN, NNP-BC
• Julia Christine Carpenter, MA, CCC-SLP
• Kristopher Kyle Carpenter, M.D.
• Orit K Carpenter, PSY.D.

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.