NPIMap

Organization Active NPI

Carlson Dental Office PA

  • Dentist
  • Fairmont, MN
National Provider Identifier
1184637258
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11032 Issued in MN
Legal business name
CARLSON DENTAL OFFICE PA
Practice address
717 S State St
Ste 700
Fairmont, MN 56031-4469
Phone
(507) 238-1883
Fax
(507) 238-1612
NPI assigned
Aug 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Paul F Carlson, DDSNPI 1396758462
Title
Dentist Owner
Phone
(507) 238-1883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6851 MN
Dentist 122300000X 11032 MN Primary

Addresses

Primary practice location

717 S State St
Ste 700
Fairmont, MN 56031-4469

Mailing address

717 S State St
Ste 700
Fairmont, MN 56031-4469
Phone (507) 238-1883

National Provider Directory

National Provider Directory

Locations

717 S State St
Ste 700
Fairmont, MN 56031
Phone (507) 238-1883

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184637258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "STE 700",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-238-1883",
            "fax_number": "507-238-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "STE 700",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-238-1883",
            "fax_number": "507-238-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLSON DENTAL OFFICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "507-238-1883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "6851",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "11032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.