Carl Ross Provenzano is a Birmingham, Alabama based Dentist who is specialized in
General Practice Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Carl Ross Provenzano is
D-6826-C1 for General Practice Dentistry in Alabama. His current practice location is
625 19th St S, Birmingham. Patients can reach him at
205-934-4507.
Carl Ross Provenzano is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Carl Ross Provenzano speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Carl Ross Provenzano |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DDS |
| Accepts Medicare Assignment: | No |
| Practice Address: | 625 19th St S, Birmingham,
Alabama, 35233-1900 |
| Phone: | 205-934-4507 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1548895543 |
| NPI Enumeration Date: | 10 Mar, 2020 |
| NPI Last Update On: | 25 Aug, 2025 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Carl Ross Provenzano are as mentioned below.
| License Number | Specialization | State | Status | |
| D-6826-C1 | General Practice Dentistry | Alabama | Primary | |
| 41386 | General Practice Dentistry | Texas | Secondary | |
| D12166 | General Practice Dentistry | Oregon | Secondary | |
| DS045261 | General Practice Dentistry | Pennsylvania | Secondary | |
| 12799 | General Practice Dentistry | Tennessee | Secondary | |
| D-6826-C1 | Oral and Maxillofacial Surgery | Alabama | Secondary | |
| Student in an Organized Health Care Education/Training Program | | Secondary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 625 19th St S,
Birmingham, Alabama |
| Zip: | 35233-1900 |
| Phone Number: | 205-934-4507 |
Patients can reach Carl Ross Provenzano at
625 19th St S, Birmingham, Alabama or can
call to book an appointment on 205-934-4507.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.