Livewell Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN03137 Issued in RI

Legal business name

LIVEWELL DENTAL LLC

Practice address

501 Great Rd Ste 206
North Smithfield, RI 02896-6833

Phone

(401) 769-0798

Fax

(401) 762-0302

NPI assigned

Oct 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Frank Edward Gibbons, DMD

Title

Manager

Phone

(401) 769-0798

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1023394947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GREAT ROAD SUITE #206",
            "city": "NORTH SMITHFIELD",
            "state": "RI",
            "postal_code": "02896",
            "telephone_number": "401-769-0798",
            "fax_number": "401-762-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GREAT RD STE 206",
            "city": "NORTH SMITHFIELD",
            "state": "RI",
            "postal_code": "028966833",
            "telephone_number": "401-769-0798",
            "fax_number": "401-762-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVEWELL DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-24",
        "last_updated": "2011-10-24",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "401-769-0798",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN03137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.