Active NPI
Carson Dahl, DDS
- Dentist
- Ruston, LA
National Provider Identifier
1962997379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6905
- Practice address
- 702 N Trenton St
Ruston, LA 71270-3324 - Phone
- (318) 255-9440
- NPI assigned
- Jun 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6905 | LA | Primary |
Addresses
Primary practice location
702 N Trenton St
Ruston, LA 71270-3324
Mailing address
322 Old Wire Rd
Ruston, LA 71270-9503
Phone (317) 488-0345
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 |
|---|---|---|---|
| 6905 | LA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530057600000",
"number": "1962997379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 OLD WIRE RD",
"city": "RUSTON",
"state": "LA",
"postal_code": "712709503",
"telephone_number": "317-488-0345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 N TRENTON ST",
"city": "RUSTON",
"state": "LA",
"postal_code": "712703324",
"telephone_number": "318-255-9440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHL",
"first_name": "CARSON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-27",
"last_updated": "2018-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.