Individual provider Active NPI

Kyle Carlton, D.D.S

  • Dentist
  • Rice Lake, WI
National Provider Identifier
1164781209
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6878 Issued in WI
Practice address
5 West Ave
Rice Lake, WI 54868-1385
Phone
(715) 736-3500
NPI assigned
May 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6878 WI Primary

Addresses

Primary practice location

5 West Ave
Rice Lake, WI 54868-1385

Mailing address

5 West Ave
Rice Lake, WI 54868-1385
Phone (715) 736-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160510000140 WI Order and Referring Only - Other (Non-Physician) 1456640747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6878WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arrowhead Family Dental 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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1164781209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WEST AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681385",
            "telephone_number": "715-736-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 WEST AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681385",
            "telephone_number": "715-736-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLTON",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

Verify at the official NPI Registry.