DR. GREGORY S THEBERGE (NPI# 1851434070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851434070 |
| Entity Type | Individual |
| Full Name | DR. GREGORY S THEBERGE |
| Credential | DDS |
| Practice Address |
1740 Atwood Ave Johnston RI 02919-3214 |
| Practice Telephone | 4012339800 |
| Practice Fax Number | 4012339898 |
| Mailing Telephone | 4012339800 |
| Mailing Fax Number | 4012339898 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DENO2364 | RI | Dental Providers |
| Street Address |
1740 ATWOOD AVE |
| City | JOHNSTON |
| State | RI |
| Zip Code | 02919-3214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699124982 | Charles Minh Pham | Dentist | 1740 Atwood Ave, Johnston, RI 02919-3214 | 2016-06-07 |
| 1578606786 | Edward S Katz | Dentist | 1740 Atwood Ave, Johnston, RI 02919-3214 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659935757 | Cheryl K. D'itri | Massage Therapist | 2051 Plainfield Pike, Johnston, RI 02919 | 2019-04-24 |
| 1013401124 | Cigna Onsite Health LLC | Clinic/Center | 735 Greenville Ave, Bldg D, Johnston, RI 02919 | 2018-06-21 |
| 1659862803 | Michaele Marie Colizza | Massage Therapist | 1524 Atwood Ave Ste 213, Johnston, RI 02919 | 2018-05-23 |
| 1609396613 | Peter Dionisopoulos | Physical Therapist | 12 Industrial Ln, Johnston, RI 02919 | 2017-06-21 |
| 1306382932 | Marcie E Diorio | Social Worker | 1126 Hartford Avenue Tri-county Community Action Agency, Johnston, RI 02919 | 2017-01-06 |
| 1467735720 | Robert Tortolani | Pharmacist | 1387 Plaindield St., Johnston, RI 02919 | 2011-09-23 |
| 1518288075 | Vito F. Ferri | Internal Medicine | 1539 Atwood Ave., Suite 101, Johnston, RI 02919 | 2010-06-18 |
| 1497073894 | Usv Optical Inc. | Technician/Technologist | 200 Stone Hill Drive, Johnston, RI 02919 | 2010-05-10 |
| 1922239995 | Heidi C. O'grady | Physical Therapist | 1529 Atwood Avenue, Suite 202, Johnston, TX 02919 | 2009-08-07 |
| 1184855397 | Holly Batura | Counselor | 1516 Hartford Avenue, Johnston, RI 02919 | 2009-08-05 |
| Find all providers in zip 02919 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124231253 | Daniel Peter Decesare | Dentist | 1740 Atwood Ave., Johnston, RI 02919-3269 | 2007-05-07 |
| 1578606786 | Edward S Katz | Dentist | 1740 Atwood Ave, Johnston, RI 02919-3214 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447378047 | Perio Inc | Dentist | 118 Point Judith Road, Unit 3, Narragansett, RI 02882-3439 | 2007-03-26 |
| 1275666141 | George W Pirie | Dentist | 77 Toll Gate Road, Warwick, RI 02886-4443 | 2007-03-13 |
| 1225185747 | Steven Jay Peiser | Dentist | 324 Angell St, Providence, RI 02906-3205 | 2007-01-05 |
| 1508950924 | Martin Craig Nager | Dentist | 67 Jefferson Boulvard, Warwick, RI 02888-1053 | 2006-10-02 |
| 1639271554 | Jeffrey Bram Shapiro | Dentist | 189 Governor St, Providence, RI 02906 | 2006-09-01 |
| 1265542955 | George B Gettinger | Dentist | 2138 Mendon Rd Ste 201, Cumberland, RI 02864-3835 | 2006-08-30 |
| 1467465054 | Denise M Shapiro | Dentist | 40 Elmgrove Avenue, Providence, RI 02906 | 2006-08-14 |
| 1801307319 | Giuseppe Cicero | Dentist | 130 Granite St, Westerly, RI 02891-2495 | 2017-10-24 |
| 1801206677 | Periodontal Associates, Ltd. | Dentist | 189 Governor St, Providence, RI 02906-3124 | 2014-05-02 |
| 1790105401 | George B. Gettinger, Dmd, Professional Corporation | Dentist | 2138 Mendon Rd, Suite 201, Cumberland, RI 02864-3834 | 2014-04-21 |
| Find all providers with the same taxonomy | ||||
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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.