NPIMap

Organization Active NPI

Champagne and Light, DMDS, LLC

  • General Practice Dentistry
  • Providence, RI
National Provider Identifier
1548439417
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN2216 Issued in RI
Legal business name
CHAMPAGNE AND LIGHT, DMDS, LLC
Practice address
189 Waterman St
Providence, RI 02906-4014
Phone
(401) 351-0072
Fax
(401) 351-0055
NPI assigned
Feb 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Dr. Gary Douglas Light, D.M.D.NPI 1578637278
Title
Principal
Phone
(401) 351-0072

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 DEN2216 RI Primary

Addresses

Primary practice location

189 Waterman St
Providence, RI 02906-4014

Mailing address

189 Waterman St
Providence, RI 02906-4014
Phone (401) 351-0072

National Provider Directory

National Provider Directory

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": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1548439417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 WATERMAN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064014",
            "telephone_number": "401-351-0072",
            "fax_number": "401-351-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 WATERMAN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064014",
            "telephone_number": "401-351-0072",
            "fax_number": "401-351-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPAGNE AND LIGHT, DMDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "401-351-0072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN2216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 26, 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.