Periodontal Associates, LTD.

Primary specialty

DentistTaxonomy code 122300000X

License

1484 Issued in RI

Legal business name

PERIODONTAL ASSOCIATES, LTD.

Practice address

189 Governor St
Providence, RI 02906-3124

Phone

(401) 421-6464

Fax

(401) 272-3884

NPI assigned

Sep 9, 2008

Last updated

Sep 9, 2008By 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

Mrs. Diane Humphrey

Title

Manager

Phone

(401) 421-6464

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1295983781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 GOVERNOR ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063124",
            "telephone_number": "401-421-6464",
            "fax_number": "401-272-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 GOVERNOR ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063124",
            "telephone_number": "401-421-6464",
            "fax_number": "401-272-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "HUMPHREY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "401-421-6464",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "RI",
            "license": "1484",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "RI",
            "license": "2740",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winston Perez
• Aaron Perfetto, PHARMD
• Leland Kit Perice, MD
• Stacy Natalie Perin, LICSW
• Perinatal Consultants, LLC
• Periodontal Associates, LTD.
• Periodontics Incorporated
• Peris Medical Corporation
• Sidney Perkins, MD, MSC
• Elliot M Perlman, MD

• Dentist in Providence, RI
• Providers in Providence, RI by specialty
• Dentist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.