NPIMap

Organization Active NPI

Carus Dental PC

Doing business as Carus Dental Georgetown Wildwood

  • General Practice Dentistry
  • Georgetown, TX
National Provider Identifier
1386913283
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CARUS DENTAL PC
Doing business as
Carus Dental Georgetown Wildwood
Practice address
105 Wildwood Dr
Suite 216
Georgetown, TX 78633-1343
Phone
(512) 942-6729
Fax
(512) 942-6846
NPI assigned
Dec 21, 2011
Last updated
Jan 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CARUS DENTAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13687 TX
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

105 Wildwood Dr
Suite 216
Georgetown, TX 78633-1343

Mailing address

105 Wildwood Dr
Suite 216
Georgetown, TX 78633-1343
Phone (512) 942-6729

Other names 1

  • Carus Dental Georgetown Wildwood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Longorn Dental41 organizations share this tax ID, including this one
Part of
Longorn Dental

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Locations

105 Wildwood Dr
Ste 216
Georgetown, TX 78633
Phone (512) 942-6729

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1386913283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WILDWOOD DR",
            "address_2": "SUITE 216",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786331343",
            "telephone_number": "512-942-6729",
            "fax_number": "512-942-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WILDWOOD DR",
            "address_2": "SUITE 216",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786331343",
            "telephone_number": "512-942-6729",
            "fax_number": "512-942-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARUS DENTAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARUS DENTAL PC",
        "enumeration_date": "2011-12-21",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13687",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carus Dental Georgetown Wildwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.