Individual provider Active NPI

Carrie Anne Carroll, D.M.D.

  • General Practice Dentistry
  • New Philadelphia, OH
National Provider Identifier
1497043566
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30023535 Issued in OH
Practice address
139 Fair Ave NE
New Philadelphia, OH 44663-2827
Phone
(330) 343-5221
Fax
(330) 343-5221
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30023535 OH Primary

Addresses

Primary practice location

139 Fair Ave NE
New Philadelphia, OH 44663-2827

Mailing address

662 Pga Blvd
New Philadelphia, OH 44663-7095
Phone (330) 934-0128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161206002027 OH Order and Referring Only - DentistPractitioner - Dentist 5799008827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30023535OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Edwin J Hawk DDS Inc 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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1497043566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 PGA BLVD",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "446637095",
            "telephone_number": "330-934-0128",
            "fax_number": "330-343-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FAIR AVE NE",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "446632827",
            "telephone_number": "330-343-5221",
            "fax_number": "330-343-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CARRIE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30023535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Philadelphia, OH

Sources for this page

Verify at the official NPI Registry.