Individual provider Active NPI

Dean Robert Carlyon, D.D.S.

  • Public Health Dentistry
  • Marquette, MI
National Provider Identifier
1902091382
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
5315004921 Issued in MI
Practice address
1960 US Hwy 41 South
Marquette Prison
Marquette, MI 49855
Phone
(906) 226-6531
Fax
(906) 226-1972
NPI assigned
Sep 10, 2007
Last updated
Sep 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 5315004921 MI Primary

Addresses

Primary practice location

1960 US Hwy 41 South
Marquette Prison
Marquette, MI 49855

Mailing address

PO Box 96
Marquette, MI 49855-0096
Phone (906) 343-6776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5315004921MIMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1902091382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498550096",
            "telephone_number": "906-343-6776",
            "fax_number": "906-226-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 US HWY 41 SOUTH",
            "address_2": "MARQUETTE PRISON",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-226-6531",
            "fax_number": "906-226-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLYON",
        "first_name": "DEAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MI",
            "license": "5315004921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.