Paul F Carlson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

11032 Issued in MN

Practice address

717 S State St
Ste 700
Fairmont, MN 56031-4469

Phone

(507) 238-1883

Fax

(507) 238-1612

NPI assigned

Aug 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carlson Dental Office PA

  • Dentist
  • Fairmont, MN
  • NPI 1184637258
  NPD (past) Authorized official

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396758462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "STE 700",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-238-1883",
            "fax_number": "507-238-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "STE 700",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-238-1883",
            "fax_number": "507-238-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "PAUL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "11032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott P Burtis, D.C.
• James P Busche, O.D
• Shelley Busche, MSPT
• Carlson Dental Office PA
• Fredrick D Carlson, DDS
• Center for Anesthesia Services, LLC
• Ingrid Chan, M.D.
• Trevor Chan, M.D.
• Christopher L. Olsen, DDS PLLC (Larson and Olsen Dental PA)
• Michael Daniel Clancey, D.C.

• Dentist in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.