Clarence Nolan Carson III, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

M894 Issued in SD

Practice address

707 Chestnut St
Springfield, SD 57062

Phone

(605) 369-2226

NPI assigned

Oct 4, 2006

Last updated

Jul 17, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Carson Family Dentistry, Prof LLC

  dba Carson Family Dentistry

  • Dental Clinic/Center
  • Springfield, SD
  • NPI 1598011561
  Authorized official Same address or phone

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1528154234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CHESTNUT ST",
            "address_2": "PO BOX 567",
            "city": "SPRINGFIELD",
            "state": "SD",
            "postal_code": "57062",
            "telephone_number": "605-369-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "SD",
            "postal_code": "57062",
            "telephone_number": "605-369-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "CLARENCE",
        "middle_name": "NOLAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "M894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46046213100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harald Lars Aanning, MD
• Katie Brunick, MSW, LCSW, QMHP
• Carson Family Dentistry, Prof LLC (Carson Family Dentistry)
• City of Springfield Finance Office (Springfield Fire & Ambulance)
• Tiffany Davis
• H L Aanning Prof LLC
• Horizon Health Care Inc (Springfield Family Clinic)
• Kerrs Enterprises (springfield family clinic)

• Dentist in Springfield, SD
• Providers in Springfield, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.