Active NPI
Christopher Mark Carney, DDS
- Periodontics
- Mansfield, TX
National Provider Identifier
1699746966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 22210
- Practice address
- 1759 Broad Park Cir S
Ste 109
Mansfield, TX 76063-7833 - Phone
- (817) 225-6600
- Fax
- (817) 225-6601
- NPI assigned
- Jan 27, 2006
- Last updated
- Jun 22, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 22210 | TX | Primary |
Addresses
Primary practice location
1759 Broad Park Cir S
Ste 109
Mansfield, TX 76063-7833
Mailing address
1759 Broad Park Cir S
Ste 109
Mansfield, TX 76063-7833
Phone (817) 225-6600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 29, 2015 through Dec 29, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22210 | TX | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1699746966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1759 BROAD PARK CIR S",
"address_2": "STE 109",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760637833",
"telephone_number": "817-225-6600",
"fax_number": "817-225-6601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1759 BROAD PARK CIR S",
"address_2": "STE 109",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760637833",
"telephone_number": "817-225-6600",
"fax_number": "817-225-6601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNEY",
"first_name": "CHRISTOPHER",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "22210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.