DR. JAN RAY CARLSON DDS NPI 1417059478

NPI Information

  • NPI: 1417059478
  • Provider Name: DR. JAN RAY CARLSON, DDS
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • Address: 133 E FAIRMOUNT AVE STE 1
    LAKEWOOD, NY
    ZIP 14750
  • Phone: (716) 763-0130

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NPI Details

DR. Jan Ray Carlson, DDS is a pediatric dentistry dentist in Lakewood, NY. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Jan Ray Carlson, DDS NPI is 1417059478. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

133 E FAIRMOUNT AVE STE 1
LAKEWOOD, NY
ZIP 14750-950
Phone: (716) 763-0130

The enumeration date for this NPI number is 9/1/2006 and was last updated on 7/28/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry60345KANSASNo
21223P0221XDentistPediatric Dentistry058246NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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