Individual provider Active NPI

Carolyn Recupero

  • General Practice Dentistry
  • Midlothian, VA
National Provider Identifier
1508617168
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401418929 Issued in VA
Practice address
5954 Harbour Park Dr
Midlothian, VA 23112-2163
Phone
(804) 597-9656
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 0401418929 VA Primary

Addresses

Primary practice location

5954 Harbour Park Dr
Midlothian, VA 23112-2163

Mailing address

1215 Lee St Box 800740
Charlottesville, VA 22908-0816
Phone (434) 924-1774

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-3410
Phone (434) 924-1774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240815004468 VA Order and Referring Only - DentistPractitioner - Dentist 6406394873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: crecupero631940@direct.healthsystem.virginia.edu

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1508617168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX 800740",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-1774",
            "fax_number": "434-243-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5954 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-597-9656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229083410",
            "country_code": "US",
            "telephone_number": "434-924-1774",
            "fax_number": "434-243-6378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RECUPERO",
        "first_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.