Gary L. Carlson, D.D.S., P.a.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D6852 Issued in MN

Legal business name

GARY L. CARLSON, D.D.S., P.A.

Practice address

17809 Hutchins Dr
Ste 101
Minnetonka, MN 55345-4100

Phone

(952) 474-3203

Fax

(952) 474-3204

NPI assigned

Dec 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gary Leroy Carlson, D.D.S., M.S.D.

Title

President

Phone

(952) 474-3203

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538225677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17809 HUTCHINS DR",
            "address_2": "STE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454100",
            "telephone_number": "952-474-3203",
            "fax_number": "952-474-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17809 HUTCHINS DR",
            "address_2": "STE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454100",
            "telephone_number": "952-474-3203",
            "fax_number": "952-474-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY L. CARLSON, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-474-3203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D6852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn M Gardner, MYOTHERAPIST
• Susan B. Garfield, LISCW, ACSW
• Jill Marie Garnier, MD
• Tiffany Nicole Garrigan, M.P.T.
• Michael John Garvis, M.D.
• Kimberly Gascoigne
• Nicole M Gase, NP
• Leng Gauv, CRNP, FNP-C
• Kathryn Amelia Gehrig, MD
• Rebeca Emily Gendler

• Orthodontics and Dentofacial Orthopedics Dentistry in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• 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.

Verify at the official NPI Registry.