Todd Crew Carris, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60249401 Issued in WA

Practice address

322 SE 192ND Ave Ste 100
Vancouver, WA 98683-9679

Phone

(360) 604-5873

Fax

(360) 604-5867

NPI assigned

Jun 30, 2009

Sex

Male

Sole proprietor

No

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 OR

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

State licenses

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1851529705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 SE 192ND AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839679",
            "telephone_number": "360-604-5873",
            "fax_number": "360-604-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SE 192ND AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839679",
            "telephone_number": "360-604-5873",
            "fax_number": "360-604-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIS",
        "first_name": "TODD",
        "middle_name": "CREW",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60249401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Sean Carr, LMP
• Antonio Jose Carrasco, MD, PHD
• Reynard Carrie Jr.
• Kelsey Anne Carrier
• Angelina Carrion-Epps
• Melissa Day Carroll, LICSW
• Richard Peyton Carroll Jr., D.O.
• Jeffrey Michael Carse
• Christopher E. Carson, P.A.-C.
• Phillip Carson, CDPT

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.