MEDICARE: DR. KAYLA ANN CARLUCCI

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	DS042525	PA

General Provider Information

NPI Number	:	1831724483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAYLA ANN CARLUCCI

Provider Business Mailing Address
First Line	:	315 W DRINKER ST
Second Line	:
City	:	DUNMORE
State	:	PA
Zip	:	18512-1917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1516 SCRANTON CARBONDALE HWY
Second Line	:
City	:	SCRANTON
State	:	PA
Zip	:	18508-1136
Country	:	US
Telephone Number	:	570-253-4245
Fax Number	:	570-383-2034

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

Provider Enumeration Date	:	03/04/2020
Last Update Date	:	03/13/2026

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