Individual provider Active NPI

Robert Carlson

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1043796873
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2018014355 Issued in MO
Practice address
400 E Red Bridge Rd Ste 321
Kansas City, MO 64131-4031
Phone
(816) 943-0600
NPI assigned
Jul 15, 2018
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61335 KS
General Practice Dentistry 1223G0001X 2018014355 MO Primary

Addresses

Primary practice location

400 E Red Bridge Rd Ste 321
Kansas City, MO 64131-4031

Mailing address

5309 W 64TH St
Prairie Village, KS 66208-1333
Phone (605) 228-4913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61335KSMDGeneral Practice Dentistry
2018014355MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Red Bridge Family Dental CurrentSince Jan 19, 2025 Accepting new patients
Sunnybrook Dental, LLC Past Accepting new patients
Lynn E. Murray DDS General Practice PastSince Jan 19, 2025 Accepting new patients

Locations

400 E Red Bridge Rd
Ste 321
Kansas City, MO 64131
Phone (816) 943-0600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1043796873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5309 W 64TH ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662081333",
            "telephone_number": "605-228-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E RED BRIDGE RD STE 321",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314031",
            "telephone_number": "816-943-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61335",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018014355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.