NPIMap

Organization Active NPI

Carson Family Dentistry, Prof LLC

Doing business as Carson Family Dentistry

  • Dental Clinic/Center
  • Springfield, SD
National Provider Identifier
1598011561
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
M894 Issued in SD
Legal business name
CARSON FAMILY DENTISTRY, PROF LLC
Doing business as
Carson Family Dentistry
Practice address
707 Chestnut St
Box 567
Springfield, SD 57062
Phone
(605) 369-2226
NPI assigned
Jul 27, 2012
Last updated
Jul 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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

Authorized official

Name
Dr. CL;Arence Nolan Carson III, DDSNPI 1528154234
Title
Owner, Dentist
Phone
(605) 369-2226

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X M894 SD Primary

Addresses

Primary practice location

707 Chestnut St
Box 567
Springfield, SD 57062

Mailing address

707 Chestnut St
Box 567
Springfield, SD 57062
Phone (605) 369-2226

Other identifiers 1

IdentifierTypeStateIssuer
1528154234MedicaidNE

Other names 1

  • Carson Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

707 Chestnut St
#567
Springfield, SD 57062
Phone (605) 369-2226

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343347200000",
    "number": "1598011561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CHESTNUT ST",
            "address_2": "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",
            "address_2": "BOX 567",
            "city": "SPRINGFIELD",
            "state": "SD",
            "postal_code": "57062",
            "telephone_number": "605-369-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARSON FAMILY DENTISTRY, PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "CL;ARENCE",
        "authorized_official_middle_name": "NOLAN",
        "authorized_official_title_or_position": "OWNER, DENTIST",
        "authorized_official_telephone_number": "605-369-2226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SD",
            "license": "M894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528154234",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carson Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.