Samuel Dean Carocci, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

040775 Issued in NY

Practice address

3523 Abbott Rd
Stadium Professional Building
Orchard Park, NY 14127-1710

Phone

(716) 828-1772

Fax

(716) 828-1773

NPI assigned

Aug 29, 2007

Last updated

Aug 29, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 29, 2015 through Dec 29, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1861686198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3523 ABBOTT RD",
            "address_2": "STADIUM PROFESSIONAL BUILDING",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271710",
            "telephone_number": "716-828-1772",
            "fax_number": "716-828-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3523 ABBOTT RD",
            "address_2": "STADIUM PROFESSIONAL BUILDING",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271710",
            "telephone_number": "716-828-1772",
            "fax_number": "716-828-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROCCI",
        "first_name": "SAMUEL",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01036084",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James M Cargnoni, D.C.
• Kerry A Carlone, M.S.
• Alexander Carlson, DO
• Lisa Carlson
• Mark Anthony Carlson, R.PH.
• Burdette Carpenter, ATC
• Kathleen Carpenter, LCSW-R
• Christine E Carron, NP
• Carrow Street Pediatrics, PLLC
• Valerie Robin Carrow, SLP

• General Practice Dentistry in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.