Kurt W. Carlson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8994 Issued in MN

Practice address

800 Lasalle Ave
Minneapolis, MN 55402

Phone

(612) 338-4546

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Cameo Dental, P.a.

  • General Practice Dentistry
  • Rosemount, MN
  • NPI 1255369278
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1265514533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 LASALLE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022006",
            "telephone_number": "612-338-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 LASALLE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55402",
            "telephone_number": "612-338-4546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14470 Cameo Ave W",
            "address_purpose": "LOCATION",
            "city": "Rosemount",
            "state": "MN",
            "postal_code": "550684025",
            "country_code": "US",
            "telephone_number": "651-423-2259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KURT",
        "middle_name": "W.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D8994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION NPI",
            "identifier": "1255369278",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill S Carlson, RNFA, NP
• John Carlson, N.C.B.T.M.B.
• Jordan Nicole Carlson, DPT
• Kari Carlson, MD, MPH
• Kevin Charles Carlson
• Lily Rane Carlson
• Lori Carlson
• Mallory E Carlson, L.AC
• Marcia Keeney Carlson, RD,CDE,LD
• Mariel Louise Carlson, MSW, LGSW, LMSW

• General Practice Dentistry in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.