NORTHWEST DENTAL (NPI# 1588835623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588835623 |
| Entity Type | Organization |
| Organization Name | NORTHWEST DENTAL |
| Other Organization Name | WELLONE PRIMARY MEDICAL AND DENTAL CARE |
| Practice Address |
36 Bridge Way Pascoag RI 02859-3312 |
| Mailing Address |
36 Bridge Way Po Box 312 Pascoag RI 02859-3131 |
| Practice Telephone | 4015687661 |
| Practice Fax Number | 4015670900 |
| Mailing Telephone | 4015687661 |
| Mailing Fax Number | 4015670900 |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2012-06-01 |
| Authorized Official Name | MR. PETER BANCROFT (CEO) |
| Authorized Official Telephone | 4015687661 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHWEST COMMUNITY HEALTH CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | ACF01571 | RI | Dental Providers |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
ACF01571 | RI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | NW44528 | 05 |
| Other Name | Type Code |
|---|---|
| WellOne Primary Medical and Dental Care | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | NORTHWEST DENTAL | 1327 Trent Ave N, Keizer, OR 97303 |
| Washington State Corporations | NORTHWEST DENTAL ALLIANCE, INC. | 1730 Pottery Ave, Ste 200, Port Orchard, WA 98366-2565 |
| Oregon Corporations, Companies and Business Names | NORTHWEST DENTAL ANESTHESIA,P.C. | 1891 6th Ave, West Linn, OR 97068 |
| Oregon Corporations, Companies and Business Names | NORTHWEST DENTAL ARTS | 4320 Cherry Ave Ne, Keizer, OR 97303 |
| Washington State Corporations | NORTHWEST DENTAL ARTS LLC | 8030 Bracken Pl Se, Snoqualmie, WA 98065-9257 |
| Washington State Corporations | NORTHWEST DENTAL ASSISTING SCHOOL, LLC | 22703 Bothell Everett Hwy #e, Bothell, WA 98021 |
| Oregon Corporations, Companies and Business Names | NORTHWEST DENTAL ASSOCIATES - MEDFORD, LLC | 3551 E Barnett Road, Suite 101, Medford, OR 97504 |
| Oregon Corporations, Companies and Business Names | NORTHWEST DENTAL ASSOCIATES, P.C. | 100 Spectrum Center Dr Ste 1500, Irvine, CA 92618 |
| Oklahoma Business Registrations | NORTHWEST DENTAL CARE, P.C. | 1204 W Willow Ste C, Enid, OK 73703 |
| Washington State Corporations | NORTHWEST DENTAL CONSULTING LLC | 15228 118th Ave Ne, Bothell, WA 98011-4111 |
| Street Address |
36 BRIDGE WAY |
| City | PASCOAG |
| State | RI |
| Zip Code | 02859-3312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245219070 | Northwest Community Health Care | Clinic/Center | 36 Bridge Way, Pascoag, RI 02859 | 2006-01-11 |
| 1699311753 | Miryam Amelia Boucher | Registered Nurse | 36 Bridge Way, Pascoag, RI 02859-3131 | 2019-11-25 |
| 1699335059 | Jessica Wood | Specialist/Technologist | 36 Bridge Way, Pascoag, RI 02859-3131 | 2019-06-18 |
| 1477048098 | Ashleigh Nicole Graley | Dentist | 36 Bridge Way, Pascoag, RI 02859-3131 | 2018-06-26 |
| 1275032476 | Alice Mui | Registered Nurse | 36 Bridge Way, Pascoag, RI 02859-3131 | 2018-02-03 |
| 1942721246 | Leslie Bumpus | Dentist | 36 Bridge Way, Pascoag, RI 02859-3131 | 2017-06-28 |
| 1275932311 | Sarah C. Gulla | Nurse Practitioner | 36 Bridge Way, Pascoag, RI 02859-3131 | 2014-08-14 |
| 1194134601 | Khantil R Shah | Dentist | 36 Bridge Way, Pascoag, RI 02859-3131 | 2014-08-08 |
| 1235548371 | Stephanie Pinto | Nurse Practitioner | 36 Bridge Way, Pascoag, RI 02859-3131 | 2014-08-02 |
| 1700291861 | Kendra Crotty | Registered Nurse | 36 Bridge Way, Pascoag, RI 02859-3131 | 2014-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811397763 | Patricia Scuncio | Physical Therapy Assistant | 252 Donahue Road, Pascoag, RI 02859 | 2014-08-28 |
| 1134479520 | Kimberly Mary Cote | Social Worker | 2078 Wallum Lake Rd., Pascoag, RI 02859 | 2012-09-13 |
| 1487923793 | Northwest Community Health Care | Clinic/Center | 999 S. Main Street, Pascoag, RI 02859 | 2011-12-16 |
| 1730343666 | James Edward Sullivan | Counselor | 2076 Wallum Lake Rd, Pascoag, RI 02859 | 2008-07-10 |
| 1427243682 | Julie A. Vander Schel | Counselor | 2076 Wallum Lake Road, Pascoag, RI 02859 | 2007-09-11 |
| 1699985226 | Donna Watson | Counselor | 2198 Wallum Lake Rd., Pascoag, RI 02859 | 2007-05-23 |
| 1194817197 | Purvi Chokshi | Internal Medicine | 2090 Wallum Lake Road, Pascoag, RI 02859 | 2006-09-28 |
| 1659395622 | Dennis Edward Joyce | Counselor | 2198 Wallum Lake Road, Pascoag, RI 02859 | 2006-07-26 |
| 1427087782 | Robert James Brothers | Counselor | 2198 Wallum Lake Rd, Pascoag, RI 02859 | 2006-06-30 |
| 1194002972 | Northwest Community Health Care | Community/Behavioral Health | 1 High Street, Pascoag, RI 02859 | 2011-11-08 |
| Find all providers in zip 02859 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184262198 | Beacon Dental Health Ri, PC | Clinic/Center | Beacon Dental Health Ri, P.C., 1090 New London Avenue, Cranston, RI 02920 | 2019-12-20 |
| 1760029425 | Branch Village Dental Associates LLC | Clinic/Center | 501 Great Rd Ste 101, North Smithfield, RI 02896-6833 | 2019-12-02 |
| 1720621733 | Newport Dental Associates P.C. | Clinic/Center | 11 Catherine St Unit D, Newport, RI 02840-3497 | 2019-10-22 |
| 1245894690 | North Providence Dental Associates II LLC | Clinic/Center | 1635 Mineral Spring Ave Ste 201, North Providence, RI 02904-4025 | 2019-04-30 |
| 1053803825 | Cranston Pediatric Dentistry PC | Clinic/Center | 67 Phenix Ave, Cranston, RI 02920-4233 | 2018-06-06 |
| 1912297425 | Reynaldo P Baduya Sr.,dmd | Clinic/Center | 252 Adelaide Avenue, Providence, RI 02907 | 2011-04-18 |
| 1871677583 | Mark S. Bichajian, Dmd, Inc. | Clinic/Center | 708 Warwick Ave, Warwick, RI 02888-2670 | 2006-10-25 |
| 1477545549 | The Providence Community Health Centers, Inc. | Clinic/Center | 355r Prairie Ave, Suite 3, Providence, RI 02905-1961 | 2005-08-16 |
| 1740816271 | Angell Street Dental Associates II | Clinic/Center | 425 Angell St, Providence, RI 02906-4403 | 2020-03-16 |
| 1770133985 | Capitol Hill Ffs LLC | Clinic/Center | 276 Smith St, Providence, RI 02908-4955 | 2019-09-19 |
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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.