Provider Demographics
NPI:1659469724
Name:CARINO, MICHAEL JOHN (DMD, MPH, MPA, MSST)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:CARINO
Suffix:
Gender:M
Credentials:DMD, MPH, MPA, MSST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 BANCROFT PL NW
Mailing Address - Street 2:UNIT 501
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-4026
Mailing Address - Country:US
Mailing Address - Phone:202-387-0804
Mailing Address - Fax:
Practice Address - Street 1:5109 LEESBURG PIKE
Practice Address - Street 2:HQDA OTSG
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3215
Practice Address - Country:US
Practice Address - Phone:703-681-1873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA180301223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health