Provider Demographics
NPI:1417061037
Name:SCARPINITI, RANDY ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:ANTHONY
Last Name:SCARPINITI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 S MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3369
Mailing Address - Country:US
Mailing Address - Phone:630-916-9156
Mailing Address - Fax:630-916-9162
Practice Address - Street 1:719 S MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3369
Practice Address - Country:US
Practice Address - Phone:630-916-9156
Practice Address - Fax:630-916-9162
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist