NPIMap

Individual provider Active NPI

Frank Albert Dequattro, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wakefield, RI
National Provider Identifier
1366441388
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2711 Issued in RI
Practice address
24 Salt Pond Rd
Suite C1
Wakefield, RI 02879-4314
Phone
(401) 783-9890
NPI assigned
Jul 20, 2005
Reactivated
Apr 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2711 RI Primary

Addresses

Primary practice location

24 Salt Pond Rd
Suite C1
Wakefield, RI 02879-4314

Mailing address

24 Salt Pond Rd
Suite C1
Wakefield, RI 02879-4314
Phone (401) 783-9890

Other identifiers 3

IdentifierTypeStateIssuer
175316OtherPAUNITED CONCORDIA
8770-2OtherRIBLUE CROSS BLUE SHIELD RI
FD35850MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2711RIMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Viva Medical PC Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Myorthos Rhode Island Orthodontics PC Orthodontics and Dentofacial Orthopedics PastSince Jun 16, 2024 Accepting new patients
Frank a. Dequattro, DMD Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 3

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366441388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SALT POND RD",
            "address_2": "SUITE C1",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794314",
            "telephone_number": "401-783-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 SALT POND RD",
            "address_2": "SUITE C1",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794314",
            "telephone_number": "401-783-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEQUATTRO",
        "first_name": "FRANK",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "RI",
            "license": "2711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "175316",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD RI",
            "identifier": "8770-2",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FD35850",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

  • 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.