DR. DEREK M CORNETTA (NPI# 1093128795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093128795 |
| Entity Type | Individual |
| Full Name | DR. DEREK M CORNETTA |
| Credential | D.D.S. |
| Practice Address |
6 Blackstone Valley Pl Suite 306a Lincoln RI 02865-1179 |
| Practice Telephone | 4013335500 |
| Mailing Telephone | 4013335500 |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
DN1856555 | MA | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DEN03224 | RI | Dental Providers |
| Street Address |
6 BLACKSTONE VALLEY PL SUITE 306A |
| City | LINCOLN |
| State | RI |
| Zip Code | 02865-1179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831185214 | Tiffany Collins | Nurse Practitioner | 6 Blackstone Valley Pl, Suite 701, Lincoln, RI 02865-1179 | 2005-09-21 |
| 1639628993 | Paolucci Lincoln Dental Associates, PC | Community Based Residential Treatment Facility, Mental Illness | 6 Blackstone Valley Pl, Suite 306a, Lincoln, RI 02865-1179 | 2016-09-28 |
| 1417329491 | Orthopedics Rhode Island, Inc | Orthopaedic Surgery | 6 Blackstone Valley Pl, Suite 530, Lincoln, RI 02865-1179 | 2015-10-29 |
| 1013397843 | Devereux | Community/Behavioral Health | 6 Blackstone Valley Pl, Suite 402, Lincoln, RI 02865-1179 | 2015-06-07 |
| 1619367091 | Victoria Voshchin | Nurse Practitioner | 6 Blackstone Valley Pl, Suite 701, Lincoln, RI 02865-1179 | 2015-01-23 |
| 1285033894 | Stephen J. Sowa, Dmd | Dentist | 6 Blackstone Valley Pl, Suite 306a, Lincoln, RI 02865-1179 | 2014-08-19 |
| 1972915619 | Dpb Enterprises | Home Health | 6 Blackstone Valley Pl, Suite 206, Lincoln, RI 02865-1179 | 2014-05-29 |
| 1831521202 | Healthcentric, LLC | Nurse Practitioner | 6 Blackstone Valley Pl, Suite 502, Lincoln, RI 02865-1179 | 2013-08-07 |
| 1699107565 | Christina Paula Botelho | Nurse Practitioner | 6 Blackstone Valley Pl, Suite 701, Lincoln, RI 02865-1179 | 2013-08-02 |
| 1457645004 | Rebecca Gallucci | Speech-Language Pathologist | 6 Blackstone Valley Pl, Suite 109, Lincoln, RI 02865-1179 | 2011-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346749868 | Ckri Incorporated | In Home Supportive Care | 1525 Old Louisquissett Pike, C201, Lincoln, RI 02865 | 2018-02-10 |
| 1053824805 | Daniel Boulanger | Specialist/Technologist | 1762 Louisquisset Pike, Lincoln, RI 02865 | 2017-11-14 |
| 1013449677 | Daniel Gardner | Physical Therapist | 618 George Washington Hwy, Lincoln, RI 02865 | 2017-03-31 |
| 1801335138 | Lucille Ellen Plasse | Registered Nurse | 19 Old Great Road, Lincoln, RI 02865 | 2017-02-20 |
| 1558752014 | Northern Rhode Island Cognitive Behavioral Therapy Inc | Social Worker | 640 George Washington Hwy Ste 103, Lincoln, RI 02865 | 2015-02-05 |
| 1528313004 | Sandra Faria | Counselor | 1525 Old Louisquisset Pike Ste B104, Lincoln, RI 02865 | 2012-07-19 |
| 1982832671 | Deborah F Katcher-buckley | Nurse Practitioner | 2 Wake Robin Rd Unit 201, Lincoln, RI 02865 | 2009-07-01 |
| 1558541011 | Dawn Marie Maguire | Social Worker | 640 George Washington Hwy Ste, Bdg B, Ste 103, Lincoln, RI 02865 | 2007-11-13 |
| 1477675262 | Rhode Island Hospital | Internal Medicine | 701 George Washington Hwy Ste 100, Lincoln, RI 02865 | 2007-04-04 |
| 1083789218 | Thomas Patrick Hines | Pediatrics | 6 Blackstone Valley Place Suite 306b, Lincoln, RI 02865 | 2006-11-22 |
| Find all providers in zip 02865 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346854692 | Justin Marino | Dentist | 6 Blackstone Valley Pl Bldg 3, Lincoln, RI 02865-1179 | 2020-09-03 |
| 1053922534 | Chelsea Glissman | Dentist | 751 Sterling Pkwy Ste 100, Lincoln, CA 95648-7313 | 2020-08-10 |
| 1275150401 | Vy T Vu | Dentist | 6835 S 27th St Ste 2, Lincoln, NE 68512-4824 | 2020-07-03 |
| 1326664483 | Robert Kirkland | Dentist | 1919 S 40th St Ste 200, Lincoln, NE 68506-5247 | 2020-06-24 |
| 1265058861 | Christine Ruth Bergman | Dentist | 2121 S 70th Street, Lincoln, NE 68506 | 2020-06-19 |
| 1881218428 | South Lincoln Family Dentistry LLC | Dentist | 2121 S. 70th Street, Lincoln, NE 68506 | 2020-05-29 |
| 1619529617 | Brenton Joseph Matulka | Dentist | 575 Fallbrook Blvd Ste 107, Lincoln, NE 68521-9040 | 2019-07-10 |
| 1912472192 | Lonnie R. Flagtwet, Dds | Dentist | 7121 Stephanie Ln Ste 112, Lincoln, NE 68516-5324 | 2018-10-03 |
| 1033695366 | Callie R Krajicek | Dentist | Williamsburg Dental 6930 L St., Ste B, Lincoln, NE 68510-6851 | 2018-07-19 |
| 1659857522 | Chantel Rueb Keller | Dentist | 2915 Channel Dr, Lincoln, NE 68516-4985 | 2018-07-13 |
| Find all providers in LINCOLN | ||||
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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.