John Raymond Carlson, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

016-0000741 Issued in VT

Practice address

58 Court St
Middlebury, VT 05753-1419

Phone

(802) 388-6344

Fax

(802) 388-4103

NPI assigned

Jan 10, 2006

Last updated

Jul 18, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Maple View Oral and Maxillofacial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Middlebury, VT
  • NPI 1699001024
  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1215916291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CHIPMAN HTS",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531201",
            "telephone_number": "802-388-3874",
            "fax_number": "802-388-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 COURT ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531419",
            "telephone_number": "802-388-6344",
            "fax_number": "802-388-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VT",
            "license": "016-0000741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002436",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Mark Burke, MD
• Brian Lewis Calhoun, MD
• Nicholas Cannon, D.C.
• Carolyn Huhtala Carey, MA
• Brian J Carlozzi, DO
• Paul J Caron, B.A.
• Patricia Anne Carpenter, LICMSW
• Clara Carroll
• Nicole Laprade Carter, LICSW
• Wylie Considine Cate

• Oral and Maxillofacial Surgery (Dentist) in Middlebury, VT
• Providers in Middlebury, VT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.