NPIMap

Organization Active NPI

Carus Dental PC

  • Oral and Maxillofacial Surgery (Dentist)
  • San Marcos, TX
National Provider Identifier
1902306384
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
15919 Issued in TX
Legal business name
CARUS DENTAL PC
Practice address
102 Wonder World Dr Ste 101
San Marcos, TX 78666-6080
Phone
(512) 738-8572
NPI assigned
Feb 13, 2018
Organization subpart
Yes
Parent organization
CARUS DENTAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 15919 TX Primary

Addresses

Primary practice location

102 Wonder World Dr Ste 101
San Marcos, TX 78666-6080

Mailing address

102 Wonder World Dr Ste 101
San Marcos, TX 78666-6080
Phone (512) 738-8572

Other names 1

  • Carus Surgical Center San Marcos Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Longorn Dental41 organizations share this tax ID, including this one
Part of
Longorn Dental

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1902306384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WONDER WORLD DR STE 101",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666080",
            "telephone_number": "512-738-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WONDER WORLD DR STE 101",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666080",
            "telephone_number": "512-738-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARUS DENTAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARUS DENTAL PC",
        "enumeration_date": "2018-02-13",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "15919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carus Surgical Center San Marcos",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.