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Deactivated NPI 1376667865 Deactivated / Inactive NPI Male Practitioner

Dr. Kermit Clayton Carpenter , DDS

Dentist - General Practice • Upland, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kermit Carpenter has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 19, 2007
NPI Deactivation Date March 15, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Kermit Carpenter, DDS was a registered Dentist - General Practice practicing in Upland, CA. Throughout an active medical career spanning 16 years, Dr. Carpenter provided care at the practice location at 168 N EUCLID AVE until profile deactivation on 2023-03-15.

Practice Location & Contact Primary Location

Practice Address

168 N Euclid Ave

Upland, CA 917866035

Telephone 9099828893
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Upland, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
62 Specialists

Practicing in Upland, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 15024

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Nagib Bahri

Dentist - General Practice

NPI 1205967528
NPI 1497122311

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 15, 2023

Record deactivated on March 15, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 168 N EUCLID AVE, UPLAND, CA 917866035 (Tel: 9099828893)

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Updated Business Mailing Address July 08, 2007

Registered at 1729 N REDDING WAY, UPLAND, CA 917841959 (Tel: 9099812350)

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Provider Name / Credentials Updated July 08, 2007

Recorded as KERMIT CARPENTER, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #15024 in CA)

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Initial NPI Registration & Enumeration March 19, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376667865
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 19, 2007
Last Update: July 08, 2007
Deactivation Date: March 15, 2023

Mailing Address

1729 N Redding Way

Upland, CA 917841959

Phone: 9099812350

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.