Active NPI
Cosmo Haralambidis, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Cranston, RI
National Provider Identifier
1790819985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 02666
- Practice address
- 59 Phenix Avenue
Cranston, RI 02920-4222 - Phone
- (401) 464-4999
- Fax
- (401) 464-8903
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 02666 | RI | Primary |
Addresses
Primary practice location
59 Phenix Avenue
Cranston, RI 02920-4222
Mailing address
59 Phenix Avenue
Cranston, RI 02920
Phone (401) 464-4999
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CH-28352 | Medicaid | RI | |
| RI0091 | Other | MA | BLUE CROSS DENTAL MA |
| 100-2666 | Other | RI | DELTA DENTAL RI |
| 8135-3 | Other | RI | BLUE CROSS DENTAL RI |
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 |
|---|---|---|---|
| 02666 | RI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1790819985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59 PHENIX AVENUE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "02920",
"telephone_number": "401-464-4999",
"fax_number": "401-464-8903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 PHENIX AVENUE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029204222",
"telephone_number": "401-464-4999",
"fax_number": "401-464-8903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARALAMBIDIS",
"first_name": "COSMO",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "RI",
"license": "02666",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CH-28352",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS DENTAL MA",
"identifier": "RI0091",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL RI",
"identifier": "100-2666",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS DENTAL RI",
"identifier": "8135-3",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.