Provider Demographics
NPI:1710043534
Name:CARPINITO, RENATO A (DMD)
Entity type:Individual
Prefix:DR
First Name:RENATO
Middle Name:A
Last Name:CARPINITO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA58695OtherUNITED CONCORDIA
MAX10649OtherBLUE CROSSBLUE SHIELDS MA