Individual provider Active NPI

John M Underhill, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wakefield, RI
National Provider Identifier
1699800359
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DEN2107 Issued in RI
Practice address
24 Salt Pond Rd
Suite a-3
Wakefield, RI 02879-4314
Phone
(401) 782-1221
Fax
(401) 783-4069
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DEN2107 RI Primary

Addresses

Primary practice location

24 Salt Pond Rd
Suite a-3
Wakefield, RI 02879-4314

Mailing address

24 Salt Pond Rd
Suite a-3
Wakefield, RI 02879-4314
Phone (401) 782-1221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEN2107RIMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699800359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SALT POND RD",
            "address_2": "SUITE A-3",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794314",
            "telephone_number": "401-782-1221",
            "fax_number": "401-783-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 SALT POND RD",
            "address_2": "SUITE A-3",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794314",
            "telephone_number": "401-782-1221",
            "fax_number": "401-783-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERHILL",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "RI",
            "license": "DEN2107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.