Active NPI
Lauren Nicole Carlson, DMD
- Pediatric Dentistry
- Merrillville, IN
National Provider Identifier
1922528405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 12013113A
- Practice address
- 7863 Broadway Ste 111
Merrillville, IN 46410-5530 - Phone
- (219) 769-6636
- NPI assigned
- Jun 26, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 190.031987 | IL | |
| Pediatric Dentistry | 1223P0221X | 12013113A | IN | Primary |
Addresses
Primary practice location
7863 Broadway Ste 111
Merrillville, IN 46410-5530
Mailing address
1643 W Beach Ave Unit 2
Chicago, IL 60622-2232
Phone (509) 438-6620
Other practice location 1
705 Riley Hospital Dr Ste 4205
Indianapolis, IN 46202-5109
Phone (317) 948-4238
Other practice location 2
1229 W Washington Blvd Ste 110
Chicago, IL 60607-2133
Phone (312) 757-6629
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
| License | State | Type | Specialty |
|---|---|---|---|
| 190.031987 | IL | MD | Dentist |
| 12013113A | IN | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| All Family Dental & Braces, LLC. | Pediatric Dentistry | Past | Accepting new patients |
| Childrens Dental Center of Northwest Indiana Inc | Pediatric Dentistry | Past | 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.
-
- General Practice Dentistry
- Merrillville, IN
- NPI 1083122097
Pediatric Dentistry
-
- Pediatric Dentistry
- Merrillville, IN
- NPI 1497869341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563321600000",
"number": "1922528405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1643 W BEACH AVE UNIT 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606222232",
"telephone_number": "509-438-6620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7863 BROADWAY STE 111",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464105530",
"telephone_number": "219-769-6636"
}
],
"practiceLocations": [
{
"address_1": "705 Riley Hospital Dr Ste 4205",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025109",
"country_code": "US",
"telephone_number": "317-948-4238",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1229 W Washington Blvd Ste 110",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606072133",
"country_code": "US",
"telephone_number": "312-757-6629",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARLSON",
"first_name": "LAUREN",
"middle_name": "NICOLE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-26",
"last_updated": "2019-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "190.031987",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IN",
"license": "12013113A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.