Joseph Charles Disano
Individual provider Active NPI Dentist · Wakefield, RI
NPI 1730257528 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1730257528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2640 (RI)
- Practice address
- 390 Main St
Wakefield, RI 02879-7407 - Phone
- (401) 789-8693
- Fax
- (401) 788-9438
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2640 | RI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph L. Disano D.M.D., Inc. | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2640 | RI | Yes |
Addresses
Primary practice location
390 Main St
Wakefield, RI 02879-7407
Mailing address
390 Main St
Wakefield, RI 02879-7407
Phone (401) 789-8693
Other providers in Wakefield, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.