Gaetan Donald Charbonneau, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DEN01889 Issued in RI

Practice address

24 Salt Pond Rd Suite A2
South Kingstown Office Park
Wakefield, RI 02879

Phone

(401) 783-4223

Fax

(401) 783-1228

NPI assigned

Aug 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Charbonneau Dental, LTD

  • General Practice Dentistry
  • Wakefield, RI
  • NPI 1225740988
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013926716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SALT POND RD SUITE A2",
            "address_2": "SOUTH KINGSTOWN OFFICE PARK",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "02879",
            "telephone_number": "401-783-4223",
            "fax_number": "401-783-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 SALT POND RD SUITE A2",
            "address_2": "SOUTH KINGSTOWN OFFICE PARK",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "02879",
            "telephone_number": "401-783-4223",
            "fax_number": "401-783-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONNEAU",
        "first_name": "GAETAN",
        "middle_name": "DONALD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN01889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DENTAL",
            "identifier": "84185",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CH Specialty Services Ri LLC
• Omar Chahbandar
• CHI Y Chan, DVM
• Mitchell Chan, PHARM.D
• Charbonneau Dental, LTD
• Nicholas Charbonneau
• Robert K. Chinn, M.D.
• Heena Elizabeth Choi, L.AC.
• David J Chronley, M.D.
• Brian D Cilley, DO

• Dentist in Wakefield, RI
• Providers in Wakefield, RI by specialty
• Dentist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.