NPIMap

Organization Active NPI

The Providence Community Health Centers, Inc.

Doing business as PCHC Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
National Provider Identifier
1477545549
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC.
Doing business as
PCHC Dental Clinic
Practice address
355R Prairie Ave
Suite 3
Providence, RI 02905-1961
Phone
(401) 444-0430
Fax
(401) 444-0489
NPI assigned
Aug 16, 2005
Last updated
Dec 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Kevin Cabral
Title
Cfo
Phone
(401) 444-0400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

355R Prairie Ave
Suite 3
Providence, RI 02905-1961

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Other names 1

  • PCHC Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Providence Community Health Centers Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400

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": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1477545549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355R PRAIRIE AVE",
            "address_2": "SUITE 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029051961",
            "telephone_number": "401-444-0430",
            "fax_number": "401-444-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "CABRAL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "401-444-0400"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCHC Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.