Individual provider Active NPI

Robert Dennis Carpenter, DMD

  • Oral and Maxillofacial Pathology Dentistry
  • Saratoga Springs, NY
National Provider Identifier
1033143458
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
D7931 Issued in AZ
Practice address
4 Care LN
Saratoga Springs, NY 12866-8624
Phone
(518) 583-4497
Fax
(518) 583-3779
NPI assigned
Jul 10, 2006
Last updated
Sep 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X D7931 AZ Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 037897 NY

Addresses

Primary practice location

4 Care LN
Saratoga Springs, NY 12866-8624

Mailing address

14122 W McDowell Rd Ste 201
Goodyear, AZ 85395-2505
Phone (623) 444-4521

Other identifiers 1

IdentifierTypeStateIssuer
01240248MedicaidNY

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
D7931AZMDOral and Maxillofacial Pathology Dentist
037897NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
West Valley Endodontics and Oral Surgery PLLC Oral and Maxillofacial Surgery CurrentSince Sep 15, 2019 Accepting new patients
Midwestern University PastSince Sep 29, 2024 Accepting new patients
West Valley Endodontics and Oral Surgery Inc PastSince Sep 15, 2019 Accepting new patients
Saratoga County Oral & Maxillofacial Surgery Associates Oral and Maxillofacial Surgery Past Accepting new patients

Locations

14122 W McDowell Rd
Ste 201
Goodyear, AZ 85395
Phone (623) 444-4521

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1033143458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD STE 201",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952505",
            "telephone_number": "623-444-4521",
            "fax_number": "518-583-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CARE LN",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128668624",
            "telephone_number": "518-583-4497",
            "fax_number": "518-583-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "ROBERT",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "AZ",
            "license": "D7931",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "037897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01240248",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.