Individual provider Active NPI

Martha Carr, D.D.S.

  • General Practice Dentistry
  • Mandeville, LA
National Provider Identifier
1679652465
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4931 Issued in LA
Practice address
280 Dalwill Dr
Mandeville, LA 70471-3372
Phone
(985) 727-0047
Fax
(985) 727-1282
NPI assigned
Nov 3, 2006
Last updated
Nov 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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 4931 LA Primary

Addresses

Primary practice location

280 Dalwill Dr
Mandeville, LA 70471-3372

Mailing address

280 Dalwill Dr
Mandeville, LA 70471-3372
Phone (985) 727-0047

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

State licenses

LicenseStateTypeSpecialty
4931LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mac Family Dentistry General Practice CurrentSince Nov 27, 2022 Accepting new patients

Locations

280 Dalwill Dr
Mandeville, LA 70471
Phone (985) 727-0047

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1679652465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 DALWILL DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713372",
            "telephone_number": "985-727-0047",
            "fax_number": "985-727-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 DALWILL DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713372",
            "telephone_number": "985-727-0047",
            "fax_number": "985-727-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "MARTHA",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "4931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.