West River Family Dental Brattleboro

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

016-0002226 Issued in VT

Legal business name

WEST RIVER FAMILY DENTAL BRATTLEBORO

Practice address

36 Park PL
Brattleboro, VT 05301-2802

Phone

(802) 254-8322

Fax

(802) 258-9013

NPI assigned

Jul 24, 2012

Organization subpart

No

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

Authorized official

Name

Jared Vernon Rediske, D.D.S.

Title

Owner

Phone

(802) 254-8322

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Dwight Decker, DMD

  • Dentist
  • Brattleboro, VT
  • NPI 1477634434
  NPD (past)

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1629324942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PARK PL",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053012802",
            "telephone_number": "802-254-8322",
            "fax_number": "802-258-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 PARK PL",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053012802",
            "telephone_number": "802-254-8322",
            "fax_number": "802-258-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST RIVER FAMILY DENTAL BRATTLEBORO",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "REDISKE",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-254-8322",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VT",
            "license": "016-0002226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Rose Webb
• Michele L Webster, LMHC MA
• Wellness Family Medicine PLLC
• Knowles Wentworth
• Christopher Wesolowski, M.S.W.
• West River Wellness PLLC
• Suzanne Beth West, DMD
• Suzanne May West, OTR
• Jane F. Wheeler, LADC
• Whetstone Counseling, LLC

• Dental Clinic/Center in Brattleboro, VT
• Providers in Brattleboro, VT by specialty
• Dental Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.