David A Carbonaro, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

031296 Issued in NY

Practice address

480 Perinton Hills Office Park
Fairport, NY 14450-3609

Phone

(585) 223-6040

Fax

(585) 223-3266

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740395532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 PERINTON HILLS OFFICE PARK",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503609",
            "telephone_number": "585-223-6040",
            "fax_number": "585-223-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 PERINTON HILLS OFFICE PARK",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503609",
            "telephone_number": "585-223-6040",
            "fax_number": "585-223-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONARO",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "031296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Campolieto, TSHH, MSED
• Kelsey Krueger Cannan, LMHC
• Alyssa Canton
• Michele B Capellupo, SPECIAL EDUCATOR, 17
• Frank J Carberry Jr., DDS
• Suzanne Mary Cardner, NYS LMT
• Kelly A Carey, LMT
• Katherine Carlough
• Carol B Carlson, LMHC
• Nikole Carmel, LPN

• Periodontics in Fairport, NY
• Providers in Fairport, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.