CARSON FAMILY DENTISTRY, PROF LLC (NPI# 1598011561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598011561 |
| Entity Type | Organization |
| Organization Name | CARSON FAMILY DENTISTRY, PROF LLC |
| Other Organization Name | CARSON FAMILY DENTISTRY |
| Practice Address |
707 Chestnut St Box 567 Springfield SD 57062 |
| Practice Telephone | 6053692226 |
| Mailing Telephone | 6053692226 |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-07-27 |
| Authorized Official Name | DR. CL;ARENCE NOLAN CARSON III (OWNER, DENTIST) |
| Authorized Official Telephone | 6053692226 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
M894 | SD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 1528154234 | 05 |
| Other Name | Type Code |
|---|---|
| Carson Family Dentistry | Doing Business As Name - Organization |
| Street Address |
707 CHESTNUT ST BOX 567 |
| City | SPRINGFIELD |
| State | SD |
| Zip Code | 57062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528154234 | Clarence Nolan Carson IIi | Dentist | 707 Chestnut St, Springfield, SD 57062 | 2006-10-04 |
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|---|---|---|---|---|
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| 1356324784 | Jeff Ekle | Counselor | 709 6th St., Springfield, SD 57062 | 2005-11-21 |
| 1992706519 | Mary Kathleen Miller | Pediatrics | 806 8th Street, Springfield, SD 57062 | 2005-08-04 |
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| Find all providers in zip 57062 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
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| 1275094864 | Itooth Family Dentistry, LLC | Clinic/Center | 3211 E Battlefield St Ste 100, Springfield, MO 65804-4071 | 2019-03-27 |
| 1164918868 | Noble Family Dental PC | Clinic/Center | 665 Boston Rd, Springfield, MA 01119-1303 | 2018-07-05 |
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| 1447765029 | Dental 32, L.L.C. | Clinic/Center | 2142 S Brentwood Blvd, Springfield, MO 65804-2539 | 2017-12-05 |
| 1922435148 | Kelly Dental LLC | Clinic/Center | 1655 S. Enterprise Ave Ste. A-3, Springfield, MO 65804 | 2013-10-02 |
| 1184986077 | All About Smiles Lc | Clinic/Center | 1717 E Cherokee St, Suite 104, Springfield, MO 65804-2335 | 2012-06-15 |
| 1285939157 | Derek R. Kaelin D.d.s, LLC | Clinic/Center | 4205 S Nature Center Way, Springfield, MO 65804-4921 | 2011-01-24 |
| 1295030203 | Derek R. Kaelin, D.d.s, LLC | Clinic/Center | 2105 W Kearney St Ste A, Springfield, MO 65803-1666 | 2011-01-21 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 57062 |
Please comment or provide details below to improve the information on CARSON FAMILY DENTISTRY, PROF LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.