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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
DN16221 | MA | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MA | 0269441 | 05 |
Street Address |
637 MAIN STREET |
City | FITCHBURG |
State | MA |
Zip Code | 01420-3107 |
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 |
Find all providers in zip 01420 |
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 |
---|---|---|---|---|
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 |
Find all providers in FITCHBURG |
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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.