Clock Tower Oral Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CLOCK TOWER ORAL SURGERY LLC

Practice address

206 Clock Tower SQ
Portsmouth, RI 02871-1397

Phone

(401) 285-1188

NPI assigned

May 4, 2022

Last updated

May 4, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Beckie Anderson

Title

Financial Coordinator

Phone

(401) 285-1188

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651622400000",
    "number": "1255076295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CLOCK TOWER SQ",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028711397",
            "telephone_number": "401-285-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CLOCK TOWER SQ",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028711397",
            "telephone_number": "401-285-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOCK TOWER ORAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-04",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "BECKIE",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "401-285-1188"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Portsmouth, RI
• Providers in Portsmouth, RI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.