THE FAMILY DENTIST (NPI# 1013164920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013164920 |
| Entity Type | Organization |
| Organization Name | THE FAMILY DENTIST |
| Practice Address |
480 Broadway Pawtucket RI 02860-1340 |
| Practice Telephone | 4017286654 |
| Practice Fax Number | 4017285726 |
| Mailing Telephone | 4017286654 |
| Mailing Fax Number | 4017285726 |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |
| Authorized Official Name | DR. MICHAEL A. WAGNER (PRESIDENT) |
| Authorized Official Telephone | 4017286654 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2342 | RI | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | The Family Dentist | 4850 W. 80th Avenue, Westminster, CO 80030 |
| Colorado Business Entities | The Family Dentist, Alexander W. Smith, PhD, DMD | 4850 W. 80th Avenue, Westminster, CO 80030 |
| Street Address |
480 BROADWAY |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02860-1340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639114622 | Michael A Wagner | Dentist | 480 Broadway, Pawtucket, RI 02860 | 2006-06-17 |
| 1164439014 | Michele Gendron Siler | Dentist | 480 Broadway, Pawtucket, RI 02860 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972096923 | Lmb Medical LLC | Internal Medicine | 127 School St, Pawtucket, RI 02860 | 2018-06-13 |
| 1215420435 | Tyla Jackson | Behavior Technician | 70 Wood St Apt 22, Pawtucket, RI 02860 | 2018-06-12 |
| 1376048637 | Michael A Iadevaia | Family Medicine | 111 Brewster St Fl 3, Pawtucket, RI 02860 | 2018-03-28 |
| 1730690488 | Anthony Edwin Ramicone | Physician Assistant | 407 East Ave Ste 120, Pawtucket, RI 02860 | 2017-10-21 |
| 1669991352 | Kathleen K. Kroessler, Md; Neurology & Acupuncture, Inc. PC | Clinic/Center | 407 East Ave; Suite 110, Pawtucket, RI 02860 | 2017-09-13 |
| 1841716230 | Ri Alternative Academy Management, LLC | Local Education Agency (LEA) | 249 Roosevelt Avenue, Pawtucket, RI 02860 | 2017-08-17 |
| 1396265724 | Hannah R Stoops | Family Medicine | 111 Brewster St Fcc A, Pawtucket, RI 02860 | 2017-06-27 |
| 1427578400 | Shaun Michael Flynn | Family Medicine | 111 Brewster St, Fcc A, Pawtucket, RI 02860 | 2017-06-21 |
| 1073051843 | Laura Jane Amaral | Counselor | 750 East Ave Unit 1e, Pawtucket, RI 02860 | 2017-02-01 |
| 1063862027 | Stephanie Shoppell | Counselor | 105 Bacon Street, Pawtucket, RI 02860 | 2016-06-20 |
| Find all providers in zip 02860 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518303577 | Miguel Roca Inc | Dentist | 556 Armistice Blvd, Pawtucket, RI 02861-2630 | 2013-05-17 |
| 1356359293 | Anita N Vasvani | Dentist | 140 Newport Ave, Pawtucket, RI 02861 | 2006-08-04 |
| 1477571602 | Lindsay Ciombor Brislin | Dentist | 536 Central Ave, Pawtucket, RI 02861-1947 | 2006-07-17 |
| 1639114622 | Michael A Wagner | Dentist | 480 Broadway, Pawtucket, RI 02860 | 2006-06-17 |
| 1023317625 | Gloria Hwang | Dentist | 210 Main St, Pawtucket, RI 02860-4008 | 2011-03-22 |
| 1508029547 | Christine L Myles | Dentist | 39 East Ave, Pawtucket, RI 02860-4003 | 2008-07-09 |
| 1982726139 | H. M. Vincent, D.m.d., LLC | Dentist | 719 Armistice Blvd, Pawtucket, RI 02861-2746 | 2007-04-06 |
| 1518090463 | Mayumi R. Adriano | Dentist | 1346 Newport Ave, Pawtucket, RI 02861-1853 | 2007-03-13 |
| 1154453298 | Lalita Bhattacharya | Dentist | 42 Park Place, Pawtucket, RI 02860 | 2007-03-12 |
| 1700993730 | Yanli Ding | Dentist | 42 Park Pl, Pawtucket, RI 02860-4010 | 2006-08-24 |
| Find all providers in PAWTUCKET | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.