Individual provider Active NPI

Kevin Carter, DMD

  • General Practice Dentistry
  • Beaver, PA
National Provider Identifier
1922453000
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS044840 Issued in PA
Practice address
97 Boundry LN
Beaver, PA 15009-2949
Phone
(724) 728-0970
NPI assigned
Apr 26, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DS044840 PA Primary

Addresses

Primary practice location

97 Boundry LN
Beaver, PA 15009-2949

Mailing address

97 Boundry LN
Beaver, PA 15009-2949
Phone (740) 773-4066

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
DS044840PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Clayton Dentistry General Practice CurrentSince Nov 20, 2022 Accepting new patients
Kevin M Carter DMD PLLC General Practice Current Accepting new patients
Dennis P Clayton DMD PastSince Nov 20, 2022 Accepting new patients
Donna J Miller DMD Daniel F Green DDS and Jeremy D Crabtree DDS Inc PastSince Apr 1, 2020 Accepting new patients

Locations

97 Boundry Ln
West Bridgewater, PA 15009
Phone (724) 728-0970

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1922453000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 BOUNDRY LN",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150092949",
            "telephone_number": "740-773-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 BOUNDRY LN",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150092949",
            "telephone_number": "724-728-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS044840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.