Carol Bongiovanni, DMD
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Wakefield, RI
NPI 1184134686 · NPPES record last updated Oct 10, 2017
Key facts
- NPI
- 1184134686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- DEN02692 (RI)
- Practice address
- 24 Salt Pond Rd
Wakefield, RI 02879-4314 - Phone
- (401) 783-9890
- NPI assigned
- Oct 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN02692 | RI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DEN02692 | RI | Yes |
Addresses
Primary practice location
24 Salt Pond Rd
Wakefield, RI 02879-4314
Mailing address
232 Taylor Rd
Portsmouth, RI 02871-5419
Other providers in Wakefield, RI
- Jenna Bodurtha
- Body Mechanix Physical Therapy, Inc.
- Stacey L Bodziony
- Ryan David Boehm
- Christine Boie
- Mandy Boragine
- Jeffrey W Bouley
- Michael Patrick Bradley
- Andrea Brandon
- Neil Brandon
All providers in Wakefield, RI · Orthodontics and Dentofacial Orthopedics Dentistry in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.