Justin Carter, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7000555-9922 Issued in UT

Practice address

395 E 600 S
Preston, ID 83263-4901

Phone

(208) 852-0194

NPI assigned

Jun 12, 2008

Last updated

Mar 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Carter Healthcare Hospice of North Oklahoma, LLC

  • Community Based Hospice Care Agency
  • Pryor, OK
  • NPI 1639286032

  5% Or Greater Indirect Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Justin Carter DDS P.C.

  dba Canyon Creek Dental

  • Dentist
  • Preston, ID
  • NPI 1033849104
  NPD Authorized official
• Carter Healthcare Hospice of North Oklahoma, LLC

  • Community Based Hospice Care Agency
  • Pryor, OK
  • NPI 1639286032
  NPD Authorized official
• Caribou Family Dental

  • General Practice Dentistry
  • Grace, ID
  • NPI 1659898872
  NPD (past)
• Caribou Medical Center, Inc

  dba Caribou Medical Center

  • Clinic/Center
  • Grace, ID
  • NPI 1841485778
  NPD (past)

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646438400000",
    "number": "1386804458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 N 800 W",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832635275",
            "telephone_number": "435-757-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 E 600 S",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832634901",
            "telephone_number": "208-852-0194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 W 1st S",
            "address_purpose": "LOCATION",
            "city": "Grace",
            "state": "ID",
            "postal_code": "832415391",
            "country_code": "US",
            "telephone_number": "208-425-3123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7000555-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Scott Bontrager, MD
• Brett D Naylor DDS PA (Advanced Dental Center)
• Nathan Burnett, ATC
• Mallory Campbell, MASSAGE THERAPIST
• Heidi Carter, LMSW
• Stacey Cooper
• County of Franklin (Franklin County Ambulance)
• David Alvord Cox, D.C.
• Philip Gilbert Cromwell, O.D.
• Shannon Crowther, RDN

• General Practice Dentistry in Preston, ID
• Providers in Preston, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.