Individual provider Active NPI

Gregory Clark Carson, D.M.D.

  • General Practice Dentistry
  • Ocean City, MD
National Provider Identifier
1235235755
Registry record updated Feb 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11933 Issued in MD
Practice address
14203 Coastal Hwy
Ocean City, MD 21842-4245
Phone
(410) 250-0100
Fax
(410) 250-0100
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2009

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 11933 MD Primary

Addresses

Primary practice location

14203 Coastal Hwy
Ocean City, MD 21842-4245

Mailing address

14203 Coastal Hwy
Suite 1
Ocean City, MD 21842-4245
Phone (410) 250-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160426002089 MD Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0840599890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11933MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Oc Dental Care by Dhaliwal PC General Practice PastSince Feb 19, 2023 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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234742400000",
    "number": "1235235755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14203 COASTAL HWY",
            "address_2": "SUITE 1",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218424245",
            "telephone_number": "410-250-0100",
            "fax_number": "410-250-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14203 COASTAL HWY",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218424245",
            "telephone_number": "410-250-0100",
            "fax_number": "410-250-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "GREGORY",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2009-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean City, MD

Sources for this page

Verify at the official NPI Registry.