Individual provider Active NPI

Larry Lamar Carmichael, DMD

  • General Practice Dentistry
  • Lineville, AL
National Provider Identifier
1710081963
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3322 Issued in AL
Practice address
454 Denson Dr
Lineville, AL 36266-0159
Phone
(256) 396-2928
Fax
(256) 396-2920
NPI assigned
Sep 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3322 AL Primary

Addresses

Primary practice location

454 Denson Dr
Lineville, AL 36266-0159

Mailing address

PO Box 159
Lineville, AL 36266-0159
Phone (256) 396-2928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20151201000683 AL Order and Referring Only - DentistPractitioner - Dentist 2062712854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3322ALMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1157760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710081963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "LINEVILLE",
            "state": "AL",
            "postal_code": "362660159",
            "telephone_number": "256-396-2928",
            "fax_number": "256-396-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 DENSON DR",
            "city": "LINEVILLE",
            "state": "AL",
            "postal_code": "362660159",
            "telephone_number": "256-396-2928",
            "fax_number": "256-396-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "LARRY",
        "middle_name": "LAMAR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lineville, AL

Sources for this page

Verify at the official NPI Registry.