Individual provider Active NPI

Stephen T Carosello, DDS

  • General Practice Dentistry
  • Mentor, OH
National Provider Identifier
1164425146
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-01-4053 Issued in OH
Practice address
9500 Mentor Ave
Ste 280
Mentor, OH 44060-8715
Phone
(440) 352-2887
Fax
(440) 352-7611
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-01-4053 OH Primary

Addresses

Primary practice location

9500 Mentor Ave
Ste 280
Mentor, OH 44060-8715

Mailing address

9500 Mentor Ave
Ste 280
Mentor, OH 44060-8715
Phone (440) 352-2887

Other identifiers 1

IdentifierTypeStateIssuer
0475481MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161017001545 OH Order and Referring Only - DentistPractitioner - Dentist 0941274351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen T Carosello DDS Inc PastSince Jan 1, 1990 Accepting new patients
Lake County Dental, Jeffrey S. Rosenthal D.D.S., LLC. Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164425146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE",
            "address_2": "STE 280",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608715",
            "telephone_number": "440-352-2887",
            "fax_number": "440-352-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE",
            "address_2": "STE 280",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608715",
            "telephone_number": "440-352-2887",
            "fax_number": "440-352-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROSELLO",
        "first_name": "STEPHEN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-01-4053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0475481",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.