Individual provider Active NPI

Carrie Ann-Gilbert Mullica, DDS

  • Dentist
  • Mount Clemens, MI
National Provider Identifier
1689966376
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901018537 Issued in MI
Practice address
312 Crocker Blvd
Mount Clemens, MI 48043-2547
Phone
(586) 469-6336
Fax
(586) 469-1535
NPI assigned
May 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901018537 MI Primary

Addresses

Primary practice location

312 Crocker Blvd
Mount Clemens, MI 48043-2547

Mailing address

312 Crocker Blvd
Mount Clemens, MI 48043-2547
Phone (586) 469-6336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20161122000733 MI Order and Referring Only - DentistPractitioner - Dentist 1850670472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Gilbert DDS Dentist PastSince Aug 2, 2020 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": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1689966376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 CROCKER BLVD",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432547",
            "telephone_number": "586-469-6336",
            "fax_number": "586-469-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 CROCKER BLVD",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432547",
            "telephone_number": "586-469-6336",
            "fax_number": "586-469-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLICA",
        "first_name": "CARRIE",
        "middle_name": "ANN-GILBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.