Active NPI
Michael Eugene Carter, DDS
- General Practice Dentistry
- Fayetteville, AR
National Provider Identifier
1457375271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2439
- Practice address
- 1874 N Hunters RDG
Ste. 1
Fayetteville, AR 72701-2774 - Phone
- (479) 442-5092
- Fax
- (479) 587-0932
- NPI assigned
- Jul 26, 2006
- 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 | 2439 | AR | Primary |
Addresses
Primary practice location
1874 N Hunters RDG
Ste. 1
Fayetteville, AR 72701-2774
Mailing address
1874 N Hunters RDG
Ste. 1
Fayetteville, AR 72701-2774
Phone (479) 442-5092
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2439 | AR | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GKLM, PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457375271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1874 N HUNTERS RDG",
"address_2": "STE. 1",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727012774",
"telephone_number": "479-442-5092",
"fax_number": "479-587-0932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1874 N HUNTERS RDG",
"address_2": "STE. 1",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727012774",
"telephone_number": "479-442-5092",
"fax_number": "479-587-0932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "MICHAEL",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "2439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
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.