Organization Active NPI

Northprovidencedentalassociates

  • General Practice Dentistry
  • North Providence, RI
National Provider Identifier
1174614705
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTHPROVIDENCEDENTALASSOCIATES
Practice address
1635 Mineral Spring Ave
#201
North Providence, RI 02904-4025
Phone
(401) 353-0800
Fax
(401) 354-4240
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Peter A Macgillivray, DDS
Title
President
Phone
(401) 353-0800

Specialties & licenses 1

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

Addresses

Primary practice location

1635 Mineral Spring Ave
#201
North Providence, RI 02904-4025

Mailing address

1635 Mineral Spring Ave
#201
North Providence, RI 02904-4025
Phone (401) 353-0800

National Provider Directory

National Provider Directory

Locations

1635 Mineral Spring Ave
Ste 201
North Providence, RI 02904
Phone (401) 353-0800

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174614705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 MINERAL SPRING AVE",
            "address_2": "#201",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044025",
            "telephone_number": "401-353-0800",
            "fax_number": "401-354-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 MINERAL SPRING AVE",
            "address_2": "#201",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044025",
            "telephone_number": "401-353-0800",
            "fax_number": "401-354-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPROVIDENCEDENTALASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACGILLIVRAY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-353-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.