Provider Demographics
NPI:1659506657
Name:CARMICHAEL, WILLIAM D (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:CARMICHAEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4742 LONG BEACH ROAD SE
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-8721
Mailing Address - Country:US
Mailing Address - Phone:910-457-7167
Mailing Address - Fax:910-457-9650
Practice Address - Street 1:4742 LONG BEACH ROAD SE
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8721
Practice Address - Country:US
Practice Address - Phone:910-457-7167
Practice Address - Fax:910-457-9650
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC87521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911814Medicaid