1386186856 NPI number — DR. ALYSSA K EMORY-CARTER DDS

Table of content: DR. ALYSSA K EMORY-CARTER DDS (NPI 1386186856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386186856 NPI number — DR. ALYSSA K EMORY-CARTER DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EMORY-CARTER
Provider First Name:
ALYSSA
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EMORY
Provider Other First Name:
ALYSSA
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386186856
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2921 N HERITAGE PARKWAY
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
SHERMAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75092-4294
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-821-9855
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2921 N HERITAGE PARKWAY
Provider Second Line Business Practice Location Address:
SUITE #200
Provider Business Practice Location Address City Name:
SHERMAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75092-7509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-821-9855
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  30481 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)