Anthony Martin Carbonella IV, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

13283 Issued in CT

Practice address

30 Quaker Farms Rd
Southbury, CT 06488-2732

Phone

(203) 580-4867

NPI assigned

Jul 19, 2011

Last updated

Apr 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Rejuvenate Dental Arts PC

  • General Practice Dentistry
  • Bethel, CT
  • NPI 1255086229
  NPD (past)

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1366730798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WINTER RIDGE RD",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821099",
            "telephone_number": "752-799-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 QUAKER FARMS RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882732",
            "telephone_number": "203-580-4867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Elizabeth St",
            "address_purpose": "LOCATION",
            "city": "Bethel",
            "state": "CT",
            "postal_code": "068012100",
            "country_code": "US",
            "telephone_number": "203-797-8070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBONELLA",
        "first_name": "ANTHONY",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI 02589400",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "13283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Cade, MA, MHA, CCC-SLP
• Calmbridge Wellness LLC
• Anne Calmels, M.S., CCC/SLP
• Alexandra Camerino, OT
• Megan Elizabeth Canfield, CRNA
• Caramarie Carboni, OTR/L
• Cardiovascular Specialists of Southbury LLC
• Jerome Abellana Cariaso, MD
• Amber Carlbert, DPT
• Diane M Carlson, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Southbury, CT
• Providers in Southbury, CT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.