Individual provider Active NPI

Trena Britven Carpenter, D.D.S.

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1669532057
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6179 Issued in AZ
Practice address
5190 E Farness Dr Ste 100
Tucson, AZ 85712-2142
Phone
(520) 795-3773
Fax
(520) 795-4008
NPI assigned
Dec 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 D6179 AZ Primary

Addresses

Primary practice location

5190 E Farness Dr Ste 100
Tucson, AZ 85712-2142

Mailing address

4924 N Louis River Way
Tucson, AZ 85718-4754
Phone (520) 293-7937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150518001052 WA Order and Referring Only - Other (Non-Physician) 4082934922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D6179AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gordon K. Roediger, D.D.S., Eastside, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669532057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 N LOUIS RIVER WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857184754",
            "telephone_number": "520-293-7937",
            "fax_number": "520-795-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 E FARNESS DR STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122142",
            "telephone_number": "520-795-3773",
            "fax_number": "520-795-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "TRENA",
        "middle_name": "BRITVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D6179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.