Individual provider Active NPI

John Robert Carson, D.D.S.

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1609893304
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5396 Issued in AZ
Practice address
7415 E Tanque Verde Rd
Tucson, AZ 85715-3477
Phone
(520) 514-7203
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D5396 AZ Primary

Addresses

Primary practice location

7415 E Tanque Verde Rd
Tucson, AZ 85715-3477

Mailing address

7415 E Tanque Verde Rd
Tucson, AZ 85715-3477
Phone (520) 514-7203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150706002713 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0840502795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D5396AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John R Carson DDS PC General Practice Past Accepting new patients
John R. Carson, D.D.S., P.C. PastSince Jun 15, 2003 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609893304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7415 E TANQUE VERDE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153477",
            "telephone_number": "520-514-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7415 E TANQUE VERDE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153477",
            "telephone_number": "520-514-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.