NPIMap

Organization Active NPI

Smiles by Rosie, Inc.

  • General Practice Dentistry
  • Somerville, MA
National Provider Identifier
1326304841
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1855704 Issued in MA
Legal business name
SMILES BY ROSIE, INC.
Practice address
6 Kensington Ave
Somerville, MA 02145-2107
Phone
(617) 623-2100
NPI assigned
Apr 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Dr. Katie-Rose Radin Wagner, DDSNPI 1760793087
Title
President
Phone
(617) 623-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN1855704 MA Primary

Addresses

Primary practice location

6 Kensington Ave
Somerville, MA 02145-2107

Mailing address

6 Kensington Ave
Somerville, MA 02145-2107
Phone (617) 623-2100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1326304841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 KENSINGTON AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021452107",
            "telephone_number": "617-623-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 KENSINGTON AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021452107",
            "telephone_number": "617-623-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES BY ROSIE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "KATIE-ROSE",
        "authorized_official_middle_name": "RADIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-623-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.