Active NPI
Carmen Dilia Childers, DDS
- Dentist
- Stuart, FL
National Provider Identifier
1407247968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 20572
- Practice address
- 2835 NW Federal Hwy
Stuart, FL 34994-9252 - Phone
- (877) 343-3253
- NPI assigned
- Feb 5, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN 20572 | FL | Primary |
Addresses
Primary practice location
2835 NW Federal Hwy
Stuart, FL 34994-9252
Mailing address
6928 Villas Dr W
Boca Raton, FL 33433-5030
Phone (561) 460-4565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160222002344 | FL | Order and Referring Only - Other (Physician) | 7810292356 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 20572 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426636800000",
"number": "1407247968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6928 VILLAS DR W",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334335030",
"telephone_number": "561-460-4565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 NW FEDERAL HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349949252",
"telephone_number": "877-343-3253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDERS",
"first_name": "CARMEN",
"middle_name": "DILIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-05",
"last_updated": "2015-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN 20572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.