Individual provider Active NPI

Reagan Lonnie Carroll, DDS

  • General Practice Dentistry
  • The Woodlands, TX
National Provider Identifier
1730108036
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19438 Issued in TX
Practice address
9004 Forest Crossing Dr
Suite C
The Woodlands, TX 77381-1193
Phone
(281) 465-8844
Fax
(281) 465-9455
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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 19438 TX Primary

Addresses

Primary practice location

9004 Forest Crossing Dr
Suite C
The Woodlands, TX 77381-1193

Mailing address

9004 Forest Crossing Dr
Suite C
The Woodlands, TX 77381-1193
Phone (281) 465-8844

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
I20160408001448 TX Order and Referring Only - DentistPractitioner - Dentist 8628376522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1730108036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9004 FOREST CROSSING DR",
            "address_2": "SUITE C",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773811193",
            "telephone_number": "281-465-8844",
            "fax_number": "281-465-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9004 FOREST CROSSING DR",
            "address_2": "SUITE C",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773811193",
            "telephone_number": "281-465-8844",
            "fax_number": "281-465-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "REAGAN",
        "middle_name": "LONNIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.