Andrew James Carrell, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

12901 Issued in MN

Practice address

402 W Platt St
Maquoketa, IA 52060-2161

Phone

(563) 652-3811

Fax

(563) 652-3187

NPI assigned

Jul 29, 2010

Last updated

Dec 2, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bruce a D'Agostino DDS PC

  • General Practice Dentistry
  • Maquoketa, IA
  • NPI 1083881270
  NPD (past)

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1841504123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14475 FOREST BLVD N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550387461",
            "telephone_number": "563-652-3811",
            "fax_number": "563-652-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602161",
            "telephone_number": "563-652-3811",
            "fax_number": "563-652-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRELL",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "12901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• N Jean Brownson, MSW, LISW
• Bruce a D'Agostino DDS PC
• Tammy Sue Bullock, PHARMD
• Jerald W Bybee, MD
• Jessica Caine
• Tammy Sue Cline, BA,CADC
• Connie Jo Connolly, RPH
• Crestridge, Inc (Crestridge Care Center)
• Bruce Anthony D'Agostino, DDS
• Dac Inc

• Dentist in Maquoketa, IA
• Providers in Maquoketa, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.