Carmen Real, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

FF24 Issued in MN

Practice address

8301 W Lake CT
Chanhassen, MN 55317-8514

Phone

(952) 270-5553

NPI assigned

Mar 11, 2010

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

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: creal302181@fairview.direct-ci.com

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.

• Regents of the University of Minnesota

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1114019858
  NPD
• Regents of the University of Minnesota

  • Oral and Maxillofacial Surgery Clinic/Center
  • Minneapolis, MN
  • NPI 1164763629
  NPD
• Regents of the University of Minnesota

  • Clinic Pharmacy
  • Minneapolis, MN
  • NPI 1528288875
  NPD
• Regents of the University of Minnesota

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1457448615
  NPD (past)

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1588987135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 W LAKE CT",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553178514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 W LAKE CT",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553178514",
            "telephone_number": "952-270-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAL",
        "first_name": "CARMEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "FF24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PHS/Chanhassen,Inc.
• Katherine Stratton Posch, PSYD, LP
• Provax LLC
• Kathryn Puklich, DPT, PT
• Gail N Raether, D.D.S.
• Patrice Reed-Zweber, MA, LPCC, LADC
• Natasha-Kristin Reilly
• Allyson L Reinsch, PHARM.D.
• Miles Renswick, PHARMD
• Edward Leslie Requet, DC

• Dentist in Chanhassen, MN
• Providers in Chanhassen, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.

Verify at the official NPI Registry.