Carl Benton Fitzsimmons, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D11044 Issued in MN

Practice address

16795 County Road 24 Ste 6
Plymouth, MN 55447

Phone

(763) 577-9840

Fax

(763) 533-2034

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Carl B. Fitzsimmons, DDS, PA

  • Dental Clinic/Center
  • Plymouth, MN
  • NPI 1972894061
  NPD (past) Authorized official
• Plymouth Station Dental, PA

  • Dental Clinic/Center
  • Plymouth, MN
  • NPI 1801068663
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1396846010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16795 COUNTY ROAD 24 STE 6",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471202",
            "telephone_number": "763-577-9840",
            "fax_number": "763-577-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16795 COUNTY ROAD 24 STE 6",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55447",
            "telephone_number": "763-577-9840",
            "fax_number": "763-533-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "CARL",
        "middle_name": "BENTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Marie Fink, MS, RD, LD
• Angela Finn, NP
• Francesca Finn
• Franchesca Milagros Finn
• Vivi-Ann Rae Fischer, D.C.
• Scott Michael Flaata, DO
• Ellie Flannery, RN, CPNP
• Jeanne Fletcher, COTA
• Darlene Flint, CRNA
• Rebecca Erin Foell, MSSW LICSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.