NPIMap

Organization Active NPI

Jeffrey E Dodge DMD

  • General Practice Dentistry
  • Woonsocket, RI
National Provider Identifier
1790935831
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2227 Issued in RI
Legal business name
JEFFREY E DODGE DMD
Practice address
1438 Park Ave
Woonsocket, RI 02895-6557
Phone
(401) 762-3044
Fax
(401) 769-0603
NPI assigned
Sep 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Jeffrey E. Dodge, DMDNPI 1336170026
Title
Owner
Phone
(401) 762-3044

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2227 RI Primary

Addresses

Primary practice location

1438 Park Ave
Woonsocket, RI 02895-6557

Mailing address

1438 Park Ave
Woonsocket, RI 02895-6557
Phone (401) 762-3044

Other identifiers 2

IdentifierTypeStateIssuer
80413OtherRIBLUE CROSS DENTAL
JD01450MedicaidRI

National Provider Directory

National Provider Directory

Locations

1438 Park Ave
Woonsocket, RI 02895
Phone (401) 762-3044

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1790935831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 PARK AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956557",
            "telephone_number": "401-762-3044",
            "fax_number": "401-769-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 PARK AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956557",
            "telephone_number": "401-762-3044",
            "fax_number": "401-769-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY E DODGE DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "DODGE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-762-3044",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "2227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DENTAL",
            "identifier": "80413",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JD01450",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.