Provider Demographics
NPI:1790359131
Name:CARPINELLO, DAVID PAUL
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:CARPINELLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 PONTIAC RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4816
Mailing Address - Country:US
Mailing Address - Phone:610-446-6004
Mailing Address - Fax:610-446-0459
Practice Address - Street 1:4877 WEST CHESTER PK
Practice Address - Street 2:
Practice Address - City:EDGMONT
Practice Address - State:PA
Practice Address - Zip Code:19028
Practice Address - Country:US
Practice Address - Phone:610-353-0807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0416771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics