Active NPI
Judith Abosamra Pratt, DMD
- General Practice Dentistry
- East Greenwich, RI
National Provider Identifier
1174640817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2529
- Practice address
- 4512 Post Rd
East Greenwich, RI 02818-4124 - Phone
- (401) 884-2190
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2529 | RI | Primary |
Addresses
Primary practice location
4512 Post Rd
East Greenwich, RI 02818-4124
Mailing address
4512 Post Rd
East Greenwich, RI 02818-4124
Phone (401) 884-2190
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8165-2 | Other | RI | BLUE CROSS DENTAL |
Other names 1
- Judith Lynn Abosamra
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 |
|---|---|---|---|
| 2529 | RI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174640817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4512 POST RD",
"city": "EAST GREENWICH",
"state": "RI",
"postal_code": "028184124",
"telephone_number": "401-884-2190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4512 POST RD",
"city": "EAST GREENWICH",
"state": "RI",
"postal_code": "028184124",
"telephone_number": "401-884-2190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATT",
"first_name": "JUDITH",
"middle_name": "ABOSAMRA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "RI",
"license": "2529",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS DENTAL",
"identifier": "8165-2",
"state": "RI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JUDITH",
"last_name": "ABOSAMRA",
"middle_name": "LYNN",
"credential": "DMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in East Greenwich, RI
Sources for this page
- 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.