Carla Alldredge, DMD
Individual provider Active NPI Dentist · Newburgh, IN
NPI 1790842003 · NPPES record last updated Jun 20, 2011
Key facts
- NPI
- 1790842003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12010928A (IN)
- Practice address
- 4727 Rosebud LN Ste a
Newburgh, IN 47630-9225 - Phone
- (812) 490-9500
- Fax
- (812) 490-9595
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150427000269 | IN | Order and Referring Only - Oral Surgery |
4789903766 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19026963 | IL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 19026963 | IL | |
| Dentist | 122300000X | 12010928A | IN | Yes |
Addresses
Primary practice location
4727 Rosebud LN Ste a
Newburgh, IN 47630-9225
Mailing address
4727 Rosebud LN Ste a
Newburgh, IN 47630-9225
Phone (812) 490-9500
Other providers in Newburgh, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.