Active NPI
Erick Carlucci, DDS, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Buckeye, AZ
National Provider Identifier
1467822072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- D009348
- Practice address
- 675 S Watson Rd Ste 106
Buckeye, AZ 85326-3448 - Phone
- (760) 900-7586
- NPI assigned
- Sep 25, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | D009348 | AZ | Primary |
Addresses
Primary practice location
675 S Watson Rd Ste 106
Buckeye, AZ 85326-3448
Mailing address
16240 E Balsam Dr
Fountain Hills, AZ 85268-2219
Phone (760) 900-7586
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- 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 |
|---|---|---|---|---|
| I20160929001544 | AZ | Order and Referring Only - Other (Physician) | 5698062925 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D009348 | AZ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443139200000",
"number": "1467822072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16240 E BALSAM DR",
"city": "FOUNTAIN HILLS",
"state": "AZ",
"postal_code": "852682219",
"telephone_number": "760-900-7586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 S WATSON RD STE 106",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853263448",
"telephone_number": "760-900-7586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLUCCI",
"first_name": "ERICK",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-25",
"last_updated": "2015-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "AZ",
"license": "D009348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buckeye, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.