Active NPI
Nathan Elliot Carlson, D.M.D
- Dentist
- Philadelphia, PA
National Provider Identifier
1295933612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS031595L
- Practice address
- 3156 Kensington Ave
Philadelphia, PA 19134-2400 - Phone
- (215) 831-1100
- Fax
- (215) 807-8951
- NPI assigned
- Jul 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS031595L | PA | Primary |
Addresses
Primary practice location
3156 Kensington Ave
Philadelphia, PA 19134-2400
Mailing address
3156 Kensington Ave
Philadelphia, PA 19134-2400
Phone (215) 831-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DS031595L | Other | PA | PA DENTIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS031595L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1295933612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3156 KENSINGTON AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191342400",
"telephone_number": "215-831-1100",
"fax_number": "215-807-8951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3156 KENSINGTON AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191342400",
"telephone_number": "215-831-1100",
"fax_number": "215-807-8951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "NATHAN",
"middle_name": "ELLIOT",
"name_prefix": "Mr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-06",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS031595L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA DENTIST LICENSE",
"identifier": "DS031595L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.