Joseph Mallouh, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DEN02664 Issued in RI

Practice address

747 Victory Hwy
Slatersville, RI 02876-0130

Phone

(401) 766-2805

Fax

(401) 765-2858

NPI assigned

Aug 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Dental Associates of No. Smithfield, PC

  • General Practice Dentistry
  • Slatersville, RI
  • NPI 1720192180
  NPD (past) Authorized official

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457465809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "SLATERSVILLE",
            "state": "RI",
            "postal_code": "028760130",
            "telephone_number": "401-766-2800",
            "fax_number": "401-765-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 VICTORY HWY",
            "city": "SLATERSVILLE",
            "state": "RI",
            "postal_code": "028760130",
            "telephone_number": "401-766-2805",
            "fax_number": "401-765-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOUH",
        "first_name": "JOSEPH",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN02664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MA DENTAL",
            "identifier": "RG 0130",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DENTAL RI",
            "identifier": "8591-3",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lee Glaude-Marcos, P.T.
• Lauren Helena Herring
• Inner Light Counseling & Wellness, LLC
• Elizabeth Kubiak
• Maha Maaita, D.M.D.
• Maxi Drug South LP (Rite Aid Pharmacy 10234)
• Robert Murphy, ROBERT MURPHY
• Chan Hoon Park, MD
• Craig Anthony Simpson, M.S., P.T.
• Denise A. Sloane, D.M.D.

• Dentist in Slatersville, RI
• Providers in Slatersville, RI by specialty
• Dentist 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.