Provider Demographics
NPI:1699189647
Name:CARINO, SAMANTHA (DMD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CARINO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 CLEAR LAKE CITY BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-8039
Mailing Address - Country:US
Mailing Address - Phone:281-488-3626
Mailing Address - Fax:281-486-4766
Practice Address - Street 1:1515 E. HOSPITAL DRIVE
Practice Address - Street 2:G1218 TOWSLEY CENTER, SPC 5222
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5222
Practice Address - Country:US
Practice Address - Phone:734-232-6048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice