MEDICARE: ISAAC JOHN CARROCCIO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4535	AR

General Provider Information

NPI Number	:	1619547072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISAAC JOHN CARROCCIO DDS

Provider Business Mailing Address
First Line	:	400 RIVERWALK TER STE 250
Second Line	:
City	:	JENKS
State	:	OK
Zip	:	74037-5619
Country	:	US
Telephone Number	:	918-998-0996
Fax Number	:	918-310-1056

Provider Business Practice Location Address
First Line	:	3105 HIGHWAY 412 E
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-8635
Country	:	US
Telephone Number	:	479-373-5113
Fax Number	:	479-373-5137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2021
Last Update Date	:	06/29/2021

Similar Medicare Providers

1932442803 — BETHEL BURRIS OLIVER PLLC
Practice Location Address:

3105 HIGHWAY 412 E
SILOAM SPRINGS, AR
72761-8635

Practice Phone: 479-238-1004
Practice Fax: 479-238-1009

1942807144 — RIVER DENTAL SILOAM SPRINGS, PLLC
Practice Location Address:

3105 HIGHWAY 412 E
SILOAM SPRINGS, AR
72761-8635

Practice Phone: 479-250-0949
Practice Fax:

1457414047 — MRS. JOAN TRUGLIO L.C.S.W.
Practice Location Address:

15022 LURE TRL
BONITA SPRINGS, FL
34135-8635

Practice Phone: 631-275-3057
Practice Fax:

1790808491 — LESLIE L WAY LPC
Practice Location Address:

179 WILD ROSE DR
GLENWOOD SPRINGS, CO
81601-8635

Practice Phone: 970-379-4976
Practice Fax: 970-945-5387

1588911358 — HOWELLS ASSISTED LIVING FACILITY # 2
Practice Location Address:

541 MOUNTAIN VALLEY RD
DEFUNIAK SPRINGS, FL
32435-8635

Practice Phone: 850-892-0631
Practice Fax:

1699319590 — FRONT RANGE URGENT CARE, INC.
Practice Location Address:

6530 S ACADEMY BLVD STE 105
COLORADO SPRINGS, CO
80906-8635

Practice Phone: 719-471-2273
Practice Fax: 719-325-8954

Directions to “ ISAAC JOHN CARROCCIO DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.