Jeffrey A Carson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS7104 Issued in TN

Practice address

2175 Chambliss Ave NW
Suite C
Cleveland, TN 37311-3842

Phone

(423) 479-5966

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700963931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 CHAMBLISS AVE NW",
            "address_2": "SUITE C",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113842",
            "telephone_number": "423-479-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 CHAMBLISS AVE NW",
            "address_2": "SUITE C",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113842",
            "telephone_number": "423-479-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011354",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS7104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Stewart Carden, PA-C
• Jessica L Carney, ATC
• Carpe Diem Self Improvement Center
• Tyler Carpenter, DC
• Tanya Ann Carr, NP
• Jacqueline Jeanette Carter Gustafson, MD
• Rebecca Cartwright, STAFF PHARMACIST
• Heather Carver, LPC-MHSP
• Sandra J Casey
• Melissa Marie Casselberry, RN

• General Practice Dentistry in Cleveland, TN
• Providers in Cleveland, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.