PROSPECT CHARTERCARE SJHSRI, LLC (NPI# 1639584717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639584717 |
| Entity Type | Organization |
| Organization Name | PROSPECT CHARTERCARE SJHSRI, LLC |
| Other Organization Name | ST. JOSEPH DENTAL ASSOCIATES |
| Practice Address |
21 Peace St Providence RI 02907-1510 |
| Mailing Address |
200 High Service Ave North Providence RI 02904-5113 |
| Practice Telephone | 4014564321 |
| Practice Fax Number | 4014564369 |
| Mailing Telephone | 4014563000 |
| Mailing Fax Number | 4014563028 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |
| Authorized Official Name | ELLEN SHIN (SECRETARY) |
| Authorized Official Telephone | 3109434520 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| St. Joseph Dental Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821656034 | Prospect Chartercare Sjhsri, LLC | Internal Medicine | 200 High Service Ave, N Providence, RI 02904-5113 | 2019-06-03 |
| 1205251204 | Prospect Chartercare Sjhsri, LLC | Rehabilitation Unit | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 1871918870 | Prospect Chartercare Sjhsri, LLC | General Acute Care Hospital | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 1396160396 | Prospect Chartercare Sjhsri, LLC | Psychiatric Unit | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 1578988572 | Prospect Chartercare Sjhsri, LLC | Nutritionist | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 1588089759 | Prospect Chartercare Sjhsri, LLC | Public Health or Welfare | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-25 |
| Street Address |
21 PEACE ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02907-1510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033103098 | Stanley John Stutz Jr. | Orthopaedic Surgery | 21 Peace St, Corporate Care, Providence, RI 02907-1510 | 2005-09-07 |
| 1083249098 | Anna Lam | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2020-03-10 |
| 1447884861 | Adam Takeo Ellenthal | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2020-02-25 |
| 1275166050 | Christopher Padhi | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2020-02-19 |
| 1770040412 | Tyler Anthony Beninati | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2019-03-01 |
| 1972060606 | Gabrielle Morgan Lieberman | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2019-02-28 |
| 1962969691 | John Anthony Power IIi | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2019-02-28 |
| 1386101541 | Victoria Anne Gill | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2019-02-25 |
| 1740772037 | Tiffany Diem Tu Ngo | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2018-06-01 |
| 1841794500 | Amrita Khemka | Student in an Organized Health Care Education/Training Program | 21 Peace St, Providence, RI 02907-1510 | 2018-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518522861 | Catherine M Katzberg | Massage Therapist | Santosha Yoga Studio, 275 Reservoir Ave, Providence, RI 02907 | 2019-05-02 |
| 1104317007 | Victa LLC | Internal Medicine | 110 Elmwood Ave # A, Providence, RI 02907 | 2018-05-25 |
| 1639566987 | Southside Elementary Charter School | Local Education Agency (LEA) | 126 Somerset Street, Providence, RI 02907 | 2015-04-23 |
| 1063846558 | Achievement First Providence Mayoral Academy Charter School | Local Education Agency (LEA) | 370 Hartford Aveneue, Providence, RI 02907 | 2013-09-03 |
| 1912297425 | Reynaldo P Baduya Sr.,dmd | Clinic/Center | 252 Adelaide Avenue, Providence, RI 02907 | 2011-04-18 |
| 1821218587 | Map Behavioral Health Serv. Inc. | Community/Behavioral Health | 66 Burnett Street, Providence, RI 02907 | 2007-04-26 |
| 1548336944 | Angelica Redleaf | Chiropractor | 1196 Elmwood Avenue, Providence, RI 02907 | 2006-11-28 |
| 1174619878 | Emilio Rodriguez-peris | Internal Medicine | 655 Broad Street, Suite 201, Providence, RI 02907 | 2006-10-04 |
| 1841381555 | Maged Taman | Internal Medicine | 21 Peace Street, Providence, RI 02907 | 2006-09-27 |
| 1003924226 | Gladys V Rezendes | Psychologist | 118 Comstock Avenue, Providence, RI 02907 | 2006-08-28 |
| Find all providers in zip 02907 | ||||
| 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 |
|---|---|---|---|---|
| 1033574975 | Redwood Dental | Dentist | 271 N Spring Creek Pkwy, Suite D, Providence, UT 84332-9875 | 2015-12-18 |
| 1336492149 | Carmel Absi | Dentist | 3 Regency Plz, Providence, RI 02903-3161 | 2012-10-17 |
| 1285981530 | Jordan Joseph Hansen | Dentist | 169 N Gateway Drive, Suite 200, Providence, UT 84332 | 2012-08-06 |
| 1972734515 | Celeste C Mortenson | Dentist | 169 N Gateway Dr Ste 175, Providence, UT 84332-9825 | 2009-07-30 |
| 1740499136 | Roger N Carlsten | Dentist | 433 Lloyd Ave, Providence, RI 02906 | 2007-05-22 |
| 1053530733 | Sunnyside Family Dental | Dentist | 381 Angell St, Providence, RI 02906-3214 | 2007-04-24 |
| 1205053899 | John R Ricci | Dentist | 1252 Smith St, Providence, RI 02908 | 2007-04-18 |
| 1720111503 | Diane T Monti Markowski | Dentist | 931 Smith Street, Providence, RI 02908 | 2007-03-13 |
| 1265560445 | Jacob Werba Werba | Dentist | 655 Broad St, Providence, RI 02907-1444 | 2007-03-01 |
| 1487717302 | Ernest P. Votolato | Dentist | 266 Wayland Ave, Providence, RI 02906-4524 | 2006-12-19 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02907 |
Please comment or provide details below to improve the information on PROSPECT CHARTERCARE SJHSRI, LLC.
| 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.