Provider Demographics
NPI:1023339215
Name:CARPENTINO, YISSELL (DMD)
Entity type:Individual
Prefix:DR
First Name:YISSELL
Middle Name:
Last Name:CARPENTINO
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 1:4354 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLBROOK
Mailing Address - State:OH
Mailing Address - Zip Code:45305-1544
Mailing Address - Country:US
Mailing Address - Phone:937-848-4848
Mailing Address - Fax:
Practice Address - Street 1:4354 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BELLBROOK
Practice Address - State:OH
Practice Address - Zip Code:45305-1544
Practice Address - Country:US
Practice Address - Phone:937-848-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0238251223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry