Individual provider Active NPI

Linda Sue Carstens, DDS

  • General Practice Dentistry
  • Waukon, IA
National Provider Identifier
1124121710
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7065 Issued in IA
Practice address
18 1St Ave NW
Waukon, IA 52172
Phone
(563) 568-4528
Fax
(563) 568-6144
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7065 IA Primary

Addresses

Primary practice location

18 1St Ave NW
Waukon, IA 52172

Mailing address

18 1St Ave NW
Waukon, IA 52172
Phone (563) 568-3983

Other identifiers 2

IdentifierTypeStateIssuer
0031625MedicaidIA
1031625MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150406000503 IA Order and Referring Only - DentistPractitioner - Dentist 0547221236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7065IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Iowa Dental Professional Corporation General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124121710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 1ST AVE NW",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "52172",
            "telephone_number": "563-568-3983",
            "fax_number": "563-568-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 1ST AVE NW",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "52172",
            "telephone_number": "563-568-4528",
            "fax_number": "563-568-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSTENS",
        "first_name": "LINDA",
        "middle_name": "SUE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0031625",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031625",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukon, IA

Sources for this page

Verify at the official NPI Registry.