Provider Demographics
NPI:1972242105
Name:CARANGELO, AUSTIN JARED (DDS)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:JARED
Last Name:CARANGELO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 UMSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-2957
Mailing Address - Country:US
Mailing Address - Phone:704-252-0610
Mailing Address - Fax:
Practice Address - Street 1:951 W MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:NC
Practice Address - Zip Code:28634-9352
Practice Address - Country:US
Practice Address - Phone:704-539-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12714122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist