Individual provider Active NPI

Brian Paul Del Carlo, DDS

  • General Practice Dentistry
  • Daytona Beach, FL
National Provider Identifier
1013155563
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN30268 Issued in FL
Practice address
1540 Cornerstone Blvd Ste 100
Daytona Beach, FL 32117-7144
Phone
(630) 336-8478
NPI assigned
Jan 21, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0190-25025 IL
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN30268 FL Primary

Addresses

Primary practice location

1540 Cornerstone Blvd Ste 100
Daytona Beach, FL 32117-7144

Mailing address

6318 Martin Dr
Willowbrook, IL 60527-5328
Phone (630) 336-8478

Other identifiers 1

IdentifierTypeStateIssuer
114924900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0190-25025ILMDDentist
DN30268FLMDGeneral Practice Dentistry

Networks

  • FL HMO C-SNP
  • Freedom Health HMO Network
  • FL HMO D-SNP

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1013155563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6318 MARTIN DR",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275328",
            "telephone_number": "630-336-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 CORNERSTONE BLVD STE 100",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177144",
            "telephone_number": "630-336-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL CARLO",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-21",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "0190-25025",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN30268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114924900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.