Active NPI
Ray Rezania
- Dentist
- East Providence, RI
National Provider Identifier
1053543405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN02681
- Practice address
- 1055 South Broadway
East Providence, RI 02914 - Phone
- (401) 438-0200
- Fax
- (401) 438-0211
- NPI assigned
- Aug 19, 2009
- Last updated
- Jul 24, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN02681 | RI | Primary |
Addresses
Primary practice location
1055 South Broadway
East Providence, RI 02914
Mailing address
1055 B South Broadway Street
East Providence, RI 02914
Phone (401) 438-0200
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
| License | State | Type | Specialty |
|---|---|---|---|
| DEN02681 | RI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Globo Dental PLLC | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1053543405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 B SOUTH BROADWAY STREET",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "02914",
"telephone_number": "401-438-0200",
"fax_number": "401-438-0211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 SOUTH BROADWAY",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "02914",
"telephone_number": "401-438-0200",
"fax_number": "401-438-0211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZANIA",
"first_name": "RAY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-19",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "RI",
"license": "DEN02681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.