Provider Demographics
NPI:1962504282
Name:CARKEET, BRIAN LLOYD (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:LLOYD
Last Name:CARKEET
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:LLOYD
Other - Last Name:CARKEET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 8253
Mailing Address - Street 2:
Mailing Address - City:MAMMOTH LAKES
Mailing Address - State:CA
Mailing Address - Zip Code:93546
Mailing Address - Country:US
Mailing Address - Phone:760-914-1779
Mailing Address - Fax:
Practice Address - Street 1:645 WEST LINE STREET
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514
Practice Address - Country:US
Practice Address - Phone:760-873-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44574122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist