NPIMap

Individual provider Active NPI

Carbra J. McDonnell III

  • Dentist
  • Owings Mills, MD
National Provider Identifier
1912200759
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6166 Issued in MD
Practice address
9199 Reisterstown Rd
Suite 102 B
Owings Mills, MD 21117-4520
Phone
(410) 356-6500
Fax
(410) 356-3214
NPI assigned
Dec 17, 2010
Last updated
Dec 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6166 MD Primary

Addresses

Primary practice location

9199 Reisterstown Rd
Suite 102 B
Owings Mills, MD 21117-4520

Mailing address

9199 Reisterstown Rd
Suite 102 B
Owings Mills, MD 21117-4520
Phone (410) 356-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6166MDMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Levinson,D.D.S.,P.a. Past Accepting new patients
Prasad Challagulla,.D.M.D,P.a Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292544000000",
    "number": "1912200759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9199 REISTERSTOWN RD",
            "address_2": "SUITE 102 B",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174520",
            "telephone_number": "410-356-6500",
            "fax_number": "410-356-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9199 REISTERSTOWN RD",
            "address_2": "SUITE 102 B",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174520",
            "telephone_number": "410-356-6500",
            "fax_number": "410-356-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNELL",
        "first_name": "CARBRA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-17",
        "last_updated": "2010-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "6166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; 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.