Carol Talbott, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

014776 Issued in MO

Practice address

1611 Lurlyn Dr Ste a
Poplar Bluff, MO 63901-2763

Phone

(573) 778-0200

Fax

(573) 778-0214

NPI assigned

Aug 25, 2006

Last updated

Jul 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1477660108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 LURLYN DR STE A",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012763",
            "telephone_number": "573-778-0200",
            "fax_number": "573-778-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 LURLYN DR STE A",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012763",
            "telephone_number": "573-778-0200",
            "fax_number": "573-778-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBOTT",
        "first_name": "CAROL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402435226",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.