Individual provider Active NPI

Carlos Llanes, DMD

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1881792299
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D5461 Issued in AZ
Practice address
4921 E Bell Rd
Suite 206
Scottsdale, AZ 85254-6002
Phone
(602) 404-7700
Fax
(602) 404-7712
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D5461 AZ Primary

Addresses

Primary practice location

4921 E Bell Rd
Suite 206
Scottsdale, AZ 85254-6002

Mailing address

5025 N Central Ave
# 403
Phoenix, AZ 85012-1520
Phone (562) 212-0810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150722004280 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315250149

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881792299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5025 N CENTRAL AVE",
            "address_2": "# 403",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121520",
            "telephone_number": "562-212-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 E BELL RD",
            "address_2": "SUITE 206",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546002",
            "telephone_number": "602-404-7700",
            "fax_number": "602-404-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLANES",
        "first_name": "CARLOS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.