Peter Loren Carlson, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

343 Issued in OK

Practice address

1201 N Stonewall Ave
Suite 206
Oklahoma City, OK 73117-1214

Phone

(405) 271-4441

Fax

(405) 271-1134

NPI assigned

Jun 25, 2009

Last updated

Jun 25, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Sep 18, 2013 through Sep 18, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Integris Baptist Medical Center Inc

  dba Integris Health Baptist Medical Center

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  NPD (past)
• Okc-Oms Holdings PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Oklahoma City, OK
  • NPI 1487064002
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1881822104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17032 WOODVINE DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730127911",
            "telephone_number": "405-509-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE",
            "address_2": "SUITE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-4441",
            "fax_number": "405-271-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "PETER",
        "middle_name": "LOREN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Carlisle
• Karla Carlock
• Katherine Carlsen
• Colton Carlson
• Daisy Mabel Carlson, ARNP
• Vivian Dale Carlson
• Christopher Carlton
• Elizabeth Ann Carlton, APRN
• Jordyn T Carlton, APRN, CNP
• Rebekah M Carlton

• Oral and Maxillofacial Surgery (Dentist) in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.