Individual provider Active NPI

Dianne D Pannes, DDS

  • Dentist
  • Newport, RI
National Provider Identifier
1336158153
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
03266 Issued in RI
Practice address
136 Broadway
Newport, RI 02840-2748
Phone
(401) 846-3801
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 03266 RI Primary
Durable Medical Equipment & Medical Supplies 332B00000X 03266 RI

Addresses

Primary practice location

136 Broadway
Newport, RI 02840-2748

Mailing address

136 Broadway
Newport, RI 02840-2748
Phone (401) 846-3801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220405001236 RI Order and Referring Only - DentistPractitioner - Dentist 2961825666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Portsmouth Dental Associates PastSince Sep 29, 2019 Accepting new patients
Nathan W. Tilman, DDS, PC Durable Medical Equipment & Medical Supplies PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1336158153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 BROADWAY",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402748",
            "telephone_number": "401-846-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 BROADWAY",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402748",
            "telephone_number": "401-846-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNES",
        "first_name": "DIANNE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "03266",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "RI",
            "license": "03266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

Verify at the official NPI Registry.