Reynaldo Puertollano Baduya Sr., D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN02491 Issued in RI

Practice address

252 Adelaide Ave
Providence, RI 02907-1833

Phone

(401) 941-2600

Fax

(401) 941-2695

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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.

• Reynaldo P Baduya Sr.,DMD

  • Dental Clinic/Center
  • Providence, RI
  • NPI 1912297425
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356409247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 ADELAIDE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071833",
            "telephone_number": "401-941-2600",
            "fax_number": "401-941-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 ADELAIDE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071833",
            "telephone_number": "401-941-2600",
            "fax_number": "401-941-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADUYA",
        "first_name": "REYNALDO",
        "middle_name": "PUERTOLLANO",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN02491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Badejo, PHARMD
• James Mark Badger, PHD
• Jennifer Rose Badger, BSN, RN
• Corey J Badgett
• Khairat Badru
• Joachim Elias Badway, DC
• Edward Bae, MD
• Sarah E Baer, PT
• Melanie Rose Baeszler
• Enrique Alberto Baez Delgado, M.D.

• All providers in Providence, RI
• General Practice Dentistry in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.