MEDICARE: DR. ROBERT DENNIS CARPENTER DMD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	037897	NY
2	1223P0106X	Oral and Maxillofacial Pathology Dentistry	D7931	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033143458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT DENNIS CARPENTER DMD

Provider Business Mailing Address
First Line	:	14122 W MCDOWELL RD STE 201
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85395-2505
Country	:	US
Telephone Number	:	623-444-4521
Fax Number	:	518-583-3779

Provider Business Practice Location Address
First Line	:	4 CARE LN
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-8624
Country	:	US
Telephone Number	:	518-583-4497
Fax Number	:	518-583-3779

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	09/11/2019

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