CARLSON DISTINCTIVE DENTISTRY, PLLC (NPI# 1598243990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598243990 |
| Entity Type | Organization |
| Organization Name | CARLSON DISTINCTIVE DENTISTRY, PLLC |
| Practice Address |
1701 Curve Crest Blvd W Ste 100 Stillwater MN 55082 |
| Mailing Address |
6332 Paris Ave N Stillwater MN 55082-6828 |
| Practice Telephone | 6514398840 |
| Mailing Telephone | 6514724713 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-09-04 |
| Authorized Official Name | DR. SARAH L CARLSON (PRESIDENT/CEO) |
| Authorized Official Telephone | 6514724713 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D12115 | MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | DEA | BC9339866 | 01 |
| NPI | 1306976279 | 01 | |
| WI | WI DENTAL BOARD | 6847-15 | 01 |
| MN | MN BOARD OF DENTISTRY | D12115 | 01 |
| Street Address |
1701 CURVE CREST BLVD W STE 100 |
| City | STILLWATER |
| State | MN |
| Zip Code | 55082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| 1538453519 | Katherine Marie Corbett | Music Therapist | 105 New England Place, #150, Stillwater, MN 55082 | 2011-06-07 |
| Find all providers in zip 55082 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679190953 | Harmon Denture Clinic LLC | Dentist | 104 E Mcelroy Rd Ste 4, Stillwater, OK 74075-3803 | 2020-07-02 |
| 1922566801 | Cornerstone Family Dentistry | Dentist | 1325 S Sangre Rd, Stillwater, OK 74074-1854 | 2019-03-09 |
| 1841636586 | Russell Charles Brorsen | Dentist | 316 N Main St Ste 1, Stillwater, OK 74075-5548 | 2013-05-21 |
| 1811197882 | Sean Patrick Laidig | Dentist | 855 Eagle Ridge Ln, Stillwater, MN 55082-9171 | 2007-07-19 |
| 1205045044 | Ocean Dental, PC | Dentist | 206 W 6th Ave, Stillwater, OK 74074-4017 | 2007-05-21 |
| 1720105067 | Clinton Neal Hetrick | Dentist | 1522 W 8th Ave, Stillwater, OK 74074-4372 | 2007-03-23 |
| 1811061849 | Mathew Arnold Berg | Dentist | 510 S. Duck, Stillwater, OK 74074 | 2006-11-20 |
| 1275615635 | Robert L Moore | Dentist | 1717 W 6th, Stillwater, OK 74074 | 2006-10-19 |
| 1013014984 | Chad Brandon Hoecker | Dentist | 510 S Duck St, Stillwater, OK 74074-4051 | 2006-09-20 |
| 1336246057 | John Foran Reardon | Dentist | 333 Main St N, Suite 111, Stillwater, MN 55082-5098 | 2006-09-17 |
| Find all providers in STILLWATER | ||||
| City | STILLWATER |
| Zip Code | 55082 |
Please comment or provide details below to improve the information on CARLSON DISTINCTIVE DENTISTRY, PLLC.
| 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.