Harborside Family Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HARBORSIDE FAMILY DENTAL LLC

Practice address

600 Wampanoag TRL
Riverside, RI 02915-1511

Phone

(401) 431-2180

NPI assigned

Sep 7, 2017

Last updated

Sep 7, 2017By 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

Ms. Samantha Burnell

Title

Chief Operations Officer

Phone

(401) 578-0274

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504742400000",
    "number": "1275051450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151511",
            "telephone_number": "401-431-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORSIDE FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-09-07",
        "status": "A",
        "authorized_official_last_name": "BURNELL",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "401-578-0274",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacques Halabi, MD
• Rachel Ann Hallene, LCSW
• Jayne L Halpin, LICSW
• Teresita Hamilton, MD
• Audrey Ann Hammond, RPH
• Lorraine Marie Hardy, MSN RN AGNP-BC
• Nicholas Kerensky Harford, M.D.
• Jessica J Harris, APRN
• Dawn M Harty
• Hattie Ide Chaffee Nursing Home Inc

• General Practice Dentistry in Riverside, RI
• Providers in Riverside, RI by specialty
• General Practice Dentistry in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; 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.