Robert J Kubaska, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2072 Issued in RI

Practice address

175 Harris Avenue
Woonsocket, RI 02895-1818

Phone

(401) 762-0070

NPI assigned

Mar 29, 2007

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 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043330897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 HARRIS AVENUE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028951818",
            "telephone_number": "401-762-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 HARRIS AVENUE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028951818",
            "telephone_number": "401-762-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBASKA",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "2072",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "18933",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1379959",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DENTAL",
            "identifier": "84121",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA BLUE CROSS BLUE SHIELD",
            "identifier": "Z04702",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline H. Koury, MSW
• Vanessa Campbell Krasinski
• Katherine Krause, CCC-SLP
• Daniel Kretchman, PHD
• William J Krylowicz, R.N.
• Deborah Kutenplon, CNM
• Neung Kwon
• Stephanie M Lachance, BS
• Rachel Lacourse, PA-C
• Jessica Claire Lam

• Dentist in Woonsocket, RI
• Providers in Woonsocket, 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.