Active NPI
Nicholas Charbonneau
- General Practice Dentistry
- Wakefield, RI
National Provider Identifier
1770162984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DENO3628
- Practice address
- 24 Salt Pond Rd Ste A2
Wakefield, RI 02879-4304 - Phone
- (401) 783-4223
- NPI assigned
- Apr 5, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DENO3628 | RI | Primary |
Addresses
Primary practice location
24 Salt Pond Rd Ste A2
Wakefield, RI 02879-4304
Mailing address
24 Salt Pond Rd Ste A2
Wakefield, RI 02879-4304
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
| License | State | Type | Specialty |
|---|---|---|---|
| DENO3628 | RI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charbonneau Dental, LTD | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1770162984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 SALT POND RD STE A2",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "028794304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 SALT POND RD STE A2",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "028794304",
"telephone_number": "401-783-4223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARBONNEAU",
"first_name": "NICHOLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-05",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "RI",
"license": "DENO3628",
"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 Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.