NPIMap

Organization Active NPI

Fred J. Ravens III DDS PC

  • General Practice Dentistry
  • Reading, MA
National Provider Identifier
1366618662
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13948 Issued in MA
Legal business name
FRED J. RAVENS III DDS PC
Practice address
198 Ash St
Reading, MA 01867-3623
Phone
(781) 944-0464
NPI assigned
May 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Dr. Fred J Ravens III, DDSNPI 1043296239
Title
Owner
Phone
(781) 944-0464

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 13948 MA Primary

Addresses

Primary practice location

198 Ash St
Reading, MA 01867-3623

Mailing address

198 Ash St
Reading, MA 01867-3623
Phone (781) 944-0464

Other identifiers 1

IdentifierTypeStateIssuer
X05118OtherMABLUE CROSS BLUE SHEILD

National Provider Directory

National Provider Directory

Locations

198 Ash St
Reading, MA 01867
Phone (781) 944-0464

Practitioners & affiliated clinicians

Practitioners 2

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": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1366618662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 ASH ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "018673623",
            "telephone_number": "781-944-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 ASH ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "018673623",
            "telephone_number": "781-944-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED J. RAVENS III DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "RAVENS",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-944-0464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "13948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "X05118",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.