DR. KANDIS CARTER (NPI# 1407466337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407466337 |
| Entity Type | Individual |
| Full Name | DR. KANDIS CARTER |
| Credential | DMD |
| Practice Address |
2410 Sampson St Great Lakes IL 60088-2942 |
| Practice Telephone | 8476883331 |
| Mailing Telephone | 8476883331 |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-08-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D.0006765-C1 | AL | Dental Providers |
| Street Address |
2410 SAMPSON ST |
| City | GREAT LAKES |
| State | IL |
| Zip Code | 60088-2942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366431504 | Deborah Jeanne Galen | General Practice | 2410 Sampson St, Fisher Clinic, Bldg 237, Great Lakes, IL 60088-2942 | 2005-10-20 |
| 1346850260 | Peter Yao | Dentist | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2020-08-05 |
| 1437769361 | Gabriel Casias | Dentist | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2020-08-05 |
| 1225690670 | Jin Wung Hwang | Dentist | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2019-07-07 |
| 1821658501 | Marin Rhea Lehman | Dentist | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2019-06-16 |
| 1043878358 | Shannan Jesse Walker | Dentist | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2019-05-31 |
| 1780160556 | Clinton Bissell Butler IIi | Dentist | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2018-07-16 |
| 1942786710 | Joseph Phillip Yancho | Dentist | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2018-07-16 |
| 1174049704 | Justin Paz | Dentist | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2017-08-15 |
| 1205380664 | Rachel Newnam | Registered Nurse | 2410 Sampson St, Great Lakes, IL 60088-2942 | 2016-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858228 | Kathryn Ann Bird | Dentist | 3440 W Ohio St, Uss Osborne Branch Dental Clinic, Great Lakes, IL 60088 | 2019-12-18 |
| 1740775576 | Jonathan William Criter | Dentist | 3400 Ohio St, Great Lakes, IL 60088 | 2018-06-25 |
| 1134598733 | True Xiong | Dentist | Zachary & Elizabeth Fisher Medical & Dental Clinic, 2470 Sampson Street, Apo, AA 60088 | 2015-09-24 |
| 1447685771 | Lisa Carol Perrone | Dentist | Fhcc Lovell Bldg 237 Dental, Navsta Great Lakes, North Chicago, IL 60088 | 2013-09-05 |
| 1437438421 | David Lawrence Green | Dentist | 2410 Samson St., Bldg 237, Great Lakes, IL 60088 | 2011-08-09 |
| 1164730602 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois Street, Great Lakes, IL 60088 | 2010-09-17 |
| 1598073439 | James A Lovell Federal Health Care Center | Military/U.S. Coast Guard Pharmacy | 2430 Illinois St, Bldg 1007, Great Lakes, IL 60088 | 2010-09-14 |
| 1164736302 | Clinton Lariscy | Military Health Care Provider | 3355 Illinois St, Recruit Training Command Great Lakes, Great Lakes, IL 60088 | 2010-07-29 |
| 1083943906 | James Doll | Dentist | 2608 Paul Jones St, Great Lakes, IL 60088 | 2009-12-24 |
| 1396996823 | Kelly Robert Lanning | Dentist | 3001 A 6th St Bhc 237, Naval Hospital Great Lakes- Dental Dept., Great Lakes, IL 60088 | 2008-10-02 |
| Find all providers in zip 60088 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628948 | Won Hee Yu | Dentist | 1906 Arkansas Ave, Great Lakes, IL 60088-4243 | 2020-08-05 |
| 1043858228 | Kathryn Ann Bird | Dentist | 3440 W Ohio St, Uss Osborne Branch Dental Clinic, Great Lakes, IL 60088 | 2019-12-18 |
| 1982123790 | Jennifer Ann Kolin | Dentist | 3440 Ohio St Bldg 1017, Great Lakes, IL 60088-3155 | 2017-09-12 |
| 1437438421 | David Lawrence Green | Dentist | 2410 Samson St., Bldg 237, Great Lakes, IL 60088 | 2011-08-09 |
| 1588995377 | David Stubbs | Dentist | 2601e Paul Jones St, Building 42, Great Lakes, IL 60088-2845 | 2010-01-19 |
| 1396996823 | Kelly Robert Lanning | Dentist | 3001 A 6th St Bhc 237, Naval Hospital Great Lakes- Dental Dept., Great Lakes, IL 60088 | 2008-10-02 |
| 1225291735 | Michael Shawn Donoghue | Dentist | 3001a Sixth St Building 1017, Great Lakes, IL 60088-5230 | 2008-07-03 |
| 1730125394 | John Paul Haxton | Dentist | Fisher Clinic, 2410 Sampson St., Bldg 237, Great Lakes, IL 60088-5230 | 2006-06-21 |
| 1487629416 | Jeffrey A Staples | Dentist | 320 B St, Bldg 38h, Great Lakes, IL 60088-2815 | 2006-02-22 |
| 1336110501 | Ritesh Dhiru Radadia | Dentist | Naval Hospital Great Lakes, Bld. 200h, Great Lakes, IL 60088 | 2006-01-27 |
| Find all providers in GREAT LAKES | ||||
| City | GREAT LAKES |
| Zip Code | 60088 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.