Chuck Carlson, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

63104 Issued in CA

Practice address

3110 Sawtelle Blvd Apt 207
Los Angeles, CA 90066-1432

Phone

(949) 280-2424

NPI assigned

Mar 28, 2014

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

Enrolled in CA

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

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1902223886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 SAWTELLE BLVD APT 207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661432",
            "telephone_number": "949-280-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 SAWTELLE BLVD APT 207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661432",
            "telephone_number": "949-280-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CHUCK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "63104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oscar Angel Carlos, LVN
• Alexandra Carlson
• Annika Carlson, MD
• Cassandra Christine Carlson
• Christina Raynee Carlson, FNP
• David Scott Carlson, MA, AMFT
• Joseph Woodward Carlson, M.D., PH.D.
• Kathryn Carlson, LMFT
• Kimberly Helen Carlson, MA, MFT
• Margrit Ellen Carlson, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.