Provider Demographics
NPI:1962506428
Name:CARPIO, LILLIAN CAROL (DDS, MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:CAROL
Last Name:CARPIO
Suffix:
Gender:F
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 BEVERLY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3651
Mailing Address - Country:US
Mailing Address - Phone:703-288-3570
Mailing Address - Fax:703-288-0111
Practice Address - Street 1:1355 BEVERLY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3651
Practice Address - Country:US
Practice Address - Phone:703-288-3570
Practice Address - Fax:703-288-0111
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014107711223P0300X
FLDN 130121223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics