NPIMap

Organization Active NPI

Blackstone Valley Family Dental Associates

  • General Practice Dentistry
  • Cranston, RI
National Provider Identifier
1598043630
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN0314 Issued in RI
Legal business name
BLACKSTONE VALLEY FAMILY DENTAL ASSOCIATES
Practice address
465 Reservoir Ave
Cranston, RI 02910-1728
Phone
(401) 450-2177
Fax
(401) 450-2779
NPI assigned
Jul 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Authorized official

Name
Mr. Benjamin Rodrick
Title
Executive Administrator
Phone
(401) 450-2177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DEN0314 RI Primary

Addresses

Primary practice location

465 Reservoir Ave
Cranston, RI 02910-1728

Mailing address

465 Reservoir Ave
Cranston, RI 02910-1728

Other names 1

  • ri dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Blackstone Valley Family Dental Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

465 Reservoir Ave
Cranston, RI 02910
Phone (401) 450-2177

NPI Registry JSON

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1598043630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029101728",
            "fax_number": "401-270-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029101728",
            "telephone_number": "401-450-2177",
            "fax_number": "401-450-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSTONE VALLEY FAMILY DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "RODRICK",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "401-450-2177",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN0314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ri dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.