Individual provider Active NPI

Daniel Mackenzie Pickar, DMD

  • General Practice Dentistry
  • Cranston, RI
National Provider Identifier
1003460858
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN03480 Issued in RI
Practice address
115 Budlong Rd
Cranston, RI 02920-6429
Phone
(401) 944-8100
NPI assigned
Jul 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DEN03480 RI Primary

Addresses

Primary practice location

115 Budlong Rd
Cranston, RI 02920-6429

Mailing address

115 Budlong Rd
Cranston, RI 02920-6429
Phone (401) 944-8100

Other practice location 1

830 Chalkstone Ave Bldg 2
Providence, RI 02908-4734
Phone (401) 273-7100 ext. 4296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEN03480RIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen J Puerini DMD and Steven J Saccoccio DMD PC General Practice CurrentSince Jul 24, 2022 Accepting new patients

Locations

115 Budlong Rd
Cranston, RI 02920
Phone (401) 944-8100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1003460858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BUDLONG RD",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206429",
            "telephone_number": "401-944-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BUDLONG RD",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206429",
            "telephone_number": "401-944-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Chalkstone Ave Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084734",
            "country_code": "US",
            "telephone_number": "401-273-7100 x4296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKAR",
        "first_name": "DANIEL",
        "middle_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-30",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN03480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.