Provider Demographics
NPI:1144340399
Name:RENATO CARPINITO, D.M.D.
Entity type:Organization
Organization Name:RENATO CARPINITO, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARPINITO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-393-9000
Mailing Address - Street 1:38 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3820
Mailing Address - Country:US
Mailing Address - Phone:781-393-9000
Mailing Address - Fax:781-393-0052
Practice Address - Street 1:38 HIGH ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3820
Practice Address - Country:US
Practice Address - Phone:781-393-9000
Practice Address - Fax:781-393-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA58695OtherUNITED CONCORDIA
MAX10649OtherBC/BS DENTAL OF MA.