MR. EDWARD STEPHEN RADIVONYK JR.


Address: 637 Main Street, Fitchburg, MA 01420-3107
Phone: 9783422222

MR. EDWARD STEPHEN RADIVONYK JR. (NPI# 1336205699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336205699
Entity Type Individual
Full Name MR. EDWARD STEPHEN RADIVONYK JR.
Credential DMD
Practice Address 637 Main Street
Fitchburg
MA 01420-3107
Practice Telephone 9783422222
Practice Fax Number 9783421292
Mailing Telephone 9783422222
Mailing Fax Number 9783421292
Enumeration Date 2006-12-29
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
DN16221 MA Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
MA 0269441 05

Office Location

Street Address 637 MAIN STREET
City FITCHBURG
State MA
Zip Code 01420-3107

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NPI Name Taxonomy Address Enumeration
1063039121 Maria A Neizvestnaya Student in an Organized Health Care Education/Training Program Primary Care Behavioral Health, Fitchburg Family Medicine, Fitchburg, MA 01420 2020-07-06
1780177014 Chenell B Morris Developmental Therapist 161 Summer St, Fitchburg, MA 01420 2018-06-12
1831699578 Karen Kazanjian-silvia Social Worker 275 Nichols Rd., Healthalliance Hospital Cancer Center, Fitchburg, MA 01420 2018-02-20
1932615499 Simply Orthodontics and Pediatrics Fitchburg Pllc Dentist 50 Whalon St Ste 1, Fitchburg, MA 01420 2017-12-20
1811410517 Roger Nichele Dentist 326 Nichols St, Fitchburg, MA 01420 2017-07-25
1659893220 Fresh Start Home Care LLC Home Health 293 Arnhow Farm Road, Fitchburg, MA 01420 2017-07-14
1154864668 Kimatra Maxwell Social Worker 344 Main St Ste 9, Fitchburg, MA 01420 2016-12-01
1740635283 Henry Ntoro Sr. Nurse Practitioner 33 Electric Ave B3, Fitchburg, MA 01420 2016-05-03
1740643345 Mary Wooten Counselor 143 Highland Ave Apt 1, Fitchburg, MA 01420 2016-03-31
1013393206 Brooke Chamberland, Licsw Social Worker 982b South St, Fitchburg, MA 01420 2015-08-11
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Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700251725 Quirt Family Dentistry, Sc Dentist 5401 Caddis Bnd, Unit B, Fitchburg, WI 53711-7122 2015-12-02
1699141721 Megan Elizabeth Oldridge Dentist 2960 Triverton Pike Dr Ste 104, Fitchburg, WI 53711-7514 2015-08-12
1033518428 Derek M Levesque Dentist 26 Whalon St, Fitchburg, MA 01420-7138 2014-08-21
1760648927 Harveen Bajwa Dentist 394 Water St, Fitchburg, MA 01420-5602 2008-08-06
1396916060 Dininno Family Dental, Inc. Dentist 931 South St, Fitchburg, MA 01420-7019 2008-03-20
1730200098 Jeffrey Sharkus Dentist 5950 Seminole Centre Ct, Fitchburg, WI 53711-5023 2007-04-03
1861517104 Christopher Masse Dentist 1040 South St, Fitchburg, MA 01420-7028 2007-03-19
1083755748 Patricia J Richardson Dentist 2945 Triverton Pike Dr Ste 100, Fitchburg, WI 53711-7509 2007-02-08
1871644393 John Seaborn Sampson IIi Dentist 134 Summer St, Fitchburg, MA 01420-5869 2007-01-12
1194883868 Michael Charles Meyer Dentist 245 Summer Street, Fitchburg, MA 01420 2006-12-05
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Competitor

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City FITCHBURG
Zip Code 01420

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Dataset Information

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.

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