Dennis Lee Carlson, DDS
Individual provider Active NPI General Practice Dentistry · Virginia, MN
NPI 1225192602 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1225192602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D7791 (MN)
- Practice address
- 302 Chestnut St
200 Tini Square BLDG.
Virginia, MN 55792-2541 - Phone
- (218) 741-0089
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7791 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dennis L Carlson Family Dentistry LTD | General Practice | Past | Accepting new patients |
| Range Family Dental LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D7791 | MN | Yes |
Addresses
Primary practice location
302 Chestnut St
200 Tini Square BLDG.
Virginia, MN 55792-2541
Mailing address
302 Chestnut St
200 Tini Square BLDG.
Virginia, MN 55792-2541
Phone (218) 741-0089
Other providers in Virginia, MN
- Elizabeth Elam Burton
- Calla
- Calm Waters Therapy, LLC
- Claire Y Carlson
- Darian Carlson
- Trista Marie Carlson
- Mary J Carpenter
- Roxanne Lanae Carter-Wyatt
- Joseph F Carter
- Brenda Lee Cary
All providers in Virginia, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.