NPIMap

Organization Active NPI

Coastal Dental Associates III, LLC

  • General Practice Dentistry
  • Jamestown, RI
National Provider Identifier
1831587260
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COASTAL DENTAL ASSOCIATES III, LLC
Practice address
20 Clinton Ave
Jamestown, RI 02835-1204
Phone
(401) 423-2110
Fax
(401) 423-9224
NPI assigned
Jan 8, 2015
Last updated
Jan 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Authorized official

Name
Jennifer Kuchar, DMD
Title
Co-Owner
Phone
(773) 931-2196

Specialties & licenses 1

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

Addresses

Primary practice location

20 Clinton Ave
Jamestown, RI 02835-1204

Mailing address

20 Clinton Ave
Jamestown, RI 02835-1204
Phone (401) 423-2110

National Provider Directory

National Provider Directory

Locations

20 Clinton Ave
Jamestown, RI 02835
Phone (401) 423-2110

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1831587260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CLINTON AVE",
            "city": "JAMESTOWN",
            "state": "RI",
            "postal_code": "028351204",
            "telephone_number": "401-423-2110",
            "fax_number": "401-423-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CLINTON AVE",
            "city": "JAMESTOWN",
            "state": "RI",
            "postal_code": "028351204",
            "telephone_number": "401-423-2110",
            "fax_number": "401-423-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL DENTAL ASSOCIATES III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "KUCHAR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "773-931-2196",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.