Provider Demographics
NPI:1518344035
Name:CARNAGGIO AND PIPER DMD MS PA
Entity Type:Organization
Organization Name:CARNAGGIO AND PIPER DMD MS PA
Other - Org Name:PIEDMONT DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:CARNAGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS, PROS
Authorized Official - Phone:828-294-1448
Mailing Address - Street 1:181 W. WILKES MEDICAL CENTER RD
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:NC
Mailing Address - Zip Code:28624
Mailing Address - Country:US
Mailing Address - Phone:336-973-5060
Mailing Address - Fax:336-973-5150
Practice Address - Street 1:181 W WILKES MEDICAL CENTER RD
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:NC
Practice Address - Zip Code:28624-8925
Practice Address - Country:US
Practice Address - Phone:336-973-5060
Practice Address - Fax:336-973-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8685122300000X, 1223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1972614600Medicaid
NC1447467089Medicaid