Kimberly Carmichael, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001312-15 Issued in WI

Practice address

6217 S Packard Ave
Cudahy, WI 53110-3096

Phone

(414) 764-5550

Fax

(414) 764-9198

NPI assigned

Apr 25, 2016

Last updated

Jun 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1861847097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 LINDGREN LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610087065",
            "telephone_number": "815-721-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6217 S PACKARD AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103096",
            "telephone_number": "414-764-5550",
            "fax_number": "414-764-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "KIMBERLY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001312-15",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander C Burbach, D.C.
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• Frank A Caputo, D.D.S.
• Carbonelli Consultation
• Connie Carrao
• Samuel Andrew Carrao
• Shujahat Ali Chaudhry, M.D.
• Chiropractic Company - Cudahy LTD
• City of Cudahy (Cudahy Fire Department)

• General Practice Dentistry in Cudahy, WI
• Providers in Cudahy, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.