Thomas Jeffrey Carroll, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

047014-1 Issued in NY

Practice address

5110 Velasko Rd
Syracuse, NY 13215-1943

Phone

(315) 474-4232

Fax

(315) 474-4249

NPI assigned

Sep 1, 2006

Last updated

Mar 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1962504985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 VELASKO RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151943",
            "telephone_number": "315-474-4232",
            "fax_number": "315-474-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 VELASKO RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151943",
            "telephone_number": "315-474-4232",
            "fax_number": "315-474-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "THOMAS",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047014-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carroll Dentistry
• Andrew Mabon Carroll, MSW
• Annalise Marion Carroll
• Patricia Ann Carroll, OTR/L
• Precious Joy Carroll, REGISTERED NURSE
• Michelle Anne Carruthers, OTR/L
• Jessica Carson, LMHC
• Kelli Carsten
• Todd Clement Carsten, DDS
• Latrenda H Carswell, PT ASST

• General Practice Dentistry in Syracuse, NY
• Providers in Syracuse, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.