Individual provider Active NPI

Carolina Gerges, BDS, MS

  • Endodontics
  • College Station, TX
National Provider Identifier
1508628165
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
42000 Issued in TX
Practice address
915 William D Fitch Pkwy Ste 300
College Station, TX 77845-4638
Phone
(979) 690-7201
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 42000 TX Primary
Endodontics 1223E0200X RES004561 OH

Addresses

Primary practice location

915 William D Fitch Pkwy Ste 300
College Station, TX 77845-4638

Mailing address

3908 Eskew Dr
College Station, TX 77845-2123
Phone (551) 273-9790

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RES004561OHMDEndodontist
42000TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
College Station Modern Dentistry PC PastSince Sep 28, 2025 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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1508628165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 ESKEW DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778452123",
            "telephone_number": "551-273-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 WILLIAM D FITCH PKWY STE 300",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454638",
            "telephone_number": "979-690-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGES",
        "first_name": "CAROLINA",
        "credential": "BDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "42000",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "RES004561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.