Anthony Martin Carbonella IV, D.M.D.
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Southbury, CT
NPI 1366730798 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1366730798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 13283 (CT)
- Practice address
- 30 Quaker Farms Rd
Southbury, CT 06488-2732 - Phone
- (203) 580-4867
- NPI assigned
- Jul 19, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI 02589400 | NJ | MD | Dentist |
| 13283 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rejuvenate Dental Arts PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI 02589400 | NJ | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 13283 | CT | Yes |
Addresses
Primary practice location
30 Quaker Farms Rd
Southbury, CT 06488-2732
Mailing address
3 Winter Ridge Rd
Sandy Hook, CT 06482-1099
Phone (752) 799-8644
Other practice location 1
14 Elizabeth St
Bethel, CT 06801-2100
Phone (203) 797-8070
Other providers in Southbury, CT
- Elisabeth Cade
- Calmbridge Wellness LLC
- Anne Calmels
- Alexandra Camerino
- Megan Elizabeth Canfield
- Caramarie Carboni
- Cardiovascular Specialists of Southbury LLC
- Margaret Carey
- Jerome Abellana Cariaso
- Amber Carlbert
All providers in Southbury, CT · Orthodontics and Dentofacial Orthopedics Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.