Individual provider Active NPI

Karolyn Kay George, DDS

  • General Practice Dentistry
  • Elfrida, AZ
National Provider Identifier
1689774895
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D07772 Issued in AZ
Practice address
10566 N Highway 191
Elfrida, AZ 85610-9021
Phone
(520) 642-2222
Fax
(520) 642-3591
NPI assigned
Sep 25, 2006
Last updated
Oct 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X WY1050 WY
General Practice Dentistry 1223G0001X D07772 AZ Primary

Addresses

Primary practice location

10566 N Highway 191
Elfrida, AZ 85610-9021

Mailing address

155 Calle Portal
Suite 100
Sierra Vista, AZ 85635-2900
Phone (520) 459-3012

Other names 1

  • Kary Kay George Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160511000810 TX Order and Referring Only - DentistPractitioner - Dentist 1658660840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WY1050WYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1689774895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CALLE PORTAL",
            "address_2": "SUITE 100",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352900",
            "telephone_number": "520-459-3012",
            "fax_number": "520-559-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10566 N HIGHWAY 191",
            "city": "ELFRIDA",
            "state": "AZ",
            "postal_code": "856109021",
            "telephone_number": "520-642-2222",
            "fax_number": "520-642-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KAROLYN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "WY1050",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D07772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARY",
            "last_name": "GEORGE",
            "middle_name": "KAY",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Elfrida, AZ

Sources for this page

Verify at the official NPI Registry.