NPIMap

Organization Active NPI

Russell S. Chin, DDS, LTS

  • General Practice Dentistry
  • Pawtucket, RI
National Provider Identifier
1003905233
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1763 Issued in RI
Legal business name
RUSSELL S. CHIN, DDS, LTS
Practice address
1288 Newport Ave
Pawtucket, RI 02861-1851
Phone
(401) 728-1450
Fax
(401) 727-1488
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Dr. Russell S ChinNPI 1417910696
Title
Dentist
Phone
(401) 728-1450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1763 RI Primary

Addresses

Primary practice location

1288 Newport Ave
Pawtucket, RI 02861-1851

Mailing address

1288 Newport Ave
Pawtucket, RI 02861-1851
Phone (401) 728-1450

Other identifiers 3

IdentifierTypeStateIssuer
1763OtherRIDELTA DENTAL
8175-5OtherRIBLUE CROSS BLUE SHIELD RI
RG0025OtherMABLUE CROSS BLUE SHIELD MA

National Provider Directory

National Provider Directory

Locations

1288 Newport Ave
Pawtucket, RI 02861
Phone (401) 728-1450

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1003905233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1288 NEWPORT AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028611851",
            "telephone_number": "401-728-1450",
            "fax_number": "401-727-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 NEWPORT AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028611851",
            "telephone_number": "401-728-1450",
            "fax_number": "401-727-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL S. CHIN, DDS, LTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "CHIN",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "401-728-1450",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "1763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "1763",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD RI",
            "identifier": "8175-5",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "RG0025",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.