NPIMap

Organization Active NPI

Advanced Cosmetic Dentistry LTD

  • Periodontics
  • Cranston, RI
National Provider Identifier
1336398676
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
ADVANCED COSMETIC DENTISTRY LTD
Practice address
1090 New London Ave
Cranston, RI 02920-3035
Phone
(401) 943-6311
Fax
(401) 943-2030
NPI assigned
Sep 11, 2008
Last updated
Mar 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
Dr. Richard L Glick, DDSNPI 1528044773
Title
President
Phone
(401) 943-6311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X RI Primary

Addresses

Primary practice location

1090 New London Ave
Cranston, RI 02920-3035

Mailing address

1090 New London Ave
Cranston, RI 02920-3035
Phone (401) 943-6311

Other names 1

  • Periodontology Associates Ltd Former legal business name

National Provider Directory

National Provider Directory

Locations

1090 New London Ave
Cranston, RI 02920
Phone (401) 463-5778

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1336398676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NEW LONDON AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029203035",
            "telephone_number": "401-943-6311",
            "fax_number": "401-943-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 NEW LONDON AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029203035",
            "telephone_number": "401-943-6311",
            "fax_number": "401-943-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED COSMETIC DENTISTRY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-943-6311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Periodontology Associates Ltd",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.