Active NPI
Dennis L Carlson Family Dentistry LTD
- General Practice Dentistry
- Virginia, MN
National Provider Identifier
1477587459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D7791
- Legal business name
- DENNIS L CARLSON FAMILY DENTISTRY LTD
- Practice address
- 302 W Chestnut St
200 Tini Square BLDG
Virginia, MN 55792-2541 - Phone
- (218) 741-0089
- NPI assigned
- Jul 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dennis Lee Carlson, DDS
- Title
- Owner President
- Phone
- (218) 741-0089
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D7791 | MN | Primary |
Addresses
Primary practice location
302 W Chestnut St
200 Tini Square BLDG
Virginia, MN 55792-2541
Mailing address
302 W Chestnut St
200 Tini Square BLDG
Virginia, MN 55792-2541
Phone (218) 741-0089
National Provider Directory
National Provider DirectoryLocations
302 Chestnut St
Ste 200
Virginia, MN 55792
Phone (218) 741-0089
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1477587459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 W CHESTNUT ST",
"address_2": "200 TINI SQUARE BLDG",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "557922541",
"telephone_number": "218-741-0089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 W CHESTNUT ST",
"address_2": "200 TINI SQUARE BLDG",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "557922541",
"telephone_number": "218-741-0089"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DENNIS L CARLSON FAMILY DENTISTRY LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CARLSON",
"authorized_official_first_name": "DENNIS",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "OWNER PRESIDENT",
"authorized_official_telephone_number": "218-741-0089",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D7791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.