Michael Brian Forman, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN2031 Issued in RI

Practice address

2000 Diamond Hill Rd
Woonsocket, RI 02895-1554

Phone

(401) 766-8600

Fax

(401) 766-8601

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Woonsocket Dental Associates

  • Dental Clinic/Center
  • Woonsocket, RI
  • NPI 1861585671
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679097600000",
    "number": "1639260276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 DIAMOND HILL RD",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028951554",
            "telephone_number": "401-766-8600",
            "fax_number": "401-766-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 DIAMOND HILL RD",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028951554",
            "telephone_number": "401-766-8600",
            "fax_number": "401-766-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-03-18",
        "certification_date": "2023-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DN2031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MF02311",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariama Tejan Sie Foh, RN, MSN, DNP
• Caserra Folco
• Kenneth Elad Fonguck
• Juan Fontanez Jr., PHARM D
• Alexis Ford, PHARMD, MPH
• Glenn G. Fort, MD
• Anne Fortier, LICSW
• Tayla Foulkrod
• Sandra L Fournier, RN BSN
• Dylan Fox, PHARMD

• General Practice Dentistry in Woonsocket, RI
• Providers in Woonsocket, RI by specialty
• General Practice Dentistry in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.