Individual provider Active NPI

Emery Leigh Nicholas, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • East Greenwich, RI
National Provider Identifier
1487995445
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DEN03442 Issued in RI
Practice address
1370 S County TRL
East Greenwich, RI 02818-1625
Phone
(401) 885-1450
NPI assigned
Mar 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DEN03442 RI Primary

Addresses

Primary practice location

1370 S County TRL
East Greenwich, RI 02818-1625

Mailing address

122 Watch Hill Rd
Westerly, RI 02891-3542
Phone (203) 536-9691

Other practice location 1

122 Watch Hill Rd
Westerly, RI 02891-3542
Phone (203) 536-9691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220211002216 RI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1052704194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Oral & Maxillofacial Surgery LTD Oral and Maxillofacial Surgery PastSince Jul 25, 2019 Accepting new patients

Organizations & group practices 1

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": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1487995445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 WATCH HILL RD",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028913542",
            "telephone_number": "203-536-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 S COUNTY TRL",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028181625",
            "telephone_number": "401-885-1450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Watch Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028913542",
            "country_code": "US",
            "telephone_number": "203-536-9691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "EMERY",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-14",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "RI",
            "license": "DEN03442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenwich, RI

Sources for this page

Verify at the official NPI Registry.