Gary David Carlsen, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

21856 Issued in CA

Practice address

17822 Beach Blvd Ste 342
Huntington Beach, CA 92647-7518

Phone

(714) 847-6044

Fax

(714) 842-3145

NPI assigned

Dec 27, 2006

Last updated

Feb 23, 2009By the provider in NPPES

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)

Enrolled

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.

• Y Jun Dental Corp

  dba Surf City Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntington Beach, CA
  • NPI 1215409479
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1568527703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 342",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477518",
            "telephone_number": "714-847-6044",
            "fax_number": "714-842-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 342",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477518",
            "telephone_number": "714-847-6044",
            "fax_number": "714-842-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSEN",
        "first_name": "GARY",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "21856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Behavioral Concepts
• Care Dimensions LLC
• Carissa Karner
• Samuel Alan Carlis, D.O.
• Melanie Lynn Carlone
• Michael Lloyd Carlson, RPT
• Carmen Jan Yoo
• Andrea Jean Carmody, MED, BCBA
• Maria Carmona
• Bonnie Carnes

• Oral and Maxillofacial Surgery (Dentist) in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.