Douglas Alan Carter, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D10370 Issued in MN

Practice address

11601 Minnetonka Mills Rd
Minnetonka, MN 55305-5161

Phone

(952) 935-8420

NPI assigned

Jan 30, 2007

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 26, 2012 through Nov 26, 2026

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 and National Provider Directory roles.

• Affiliated Oral and Maxillofacial Surgeons P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Minnetonka, MN
  • NPI 1679620801
  NPD (past)
• Dental Partners of Minnesota, LTD

  • Dental Clinic/Center
  • Golden Valley, MN
  • NPI 1649353921
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376689869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 MINNETONKA MILLS RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055161",
            "telephone_number": "952-935-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 MINNETONKA MILLS RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055161",
            "telephone_number": "952-935-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "DOUGLAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D10370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "315223500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352518000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Nichole Ebnet Carlson, PT, ATC
• Charles Carodenuto, MD
• Bryn Elizabeth Carr, BA IN PSYCHOLOGY
• Laura Elizabeth Carroll, CRNP
• Rose Olson Carroll
• Lancia Dawn Carter, APRN, FNP-C
• Sierra Nicole Carter, MSW, LICSW
• Sophia Liv Emily Case
• Casey Luke Newton
• Patricia H Casey, APRN, CDE

• Oral and Maxillofacial Surgery (Dentist) in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.