Stone Bridge Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1864 Issued in RI

Legal business name

STONE BRIDGE DENTAL GROUP

Practice address

1750 Main Rd
Tiverton, RI 02878-4538

Phone

(401) 624-2375

NPI assigned

Dec 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Paul Bazzoni, DDSNPI 1891813432

Title

Employee

Phone

(401) 624-2375

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Paul E Bazzoni, DDS

  • General Practice Dentistry
  • Tiverton, RI
  • NPI 1891813432
  NPD (past) Authorized official
• Kay Jenkins, DDS

  • General Practice Dentistry
  • Tiverton, RI
  • NPI 1760509186
  NPD (past)

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1861647158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 MAIN RD",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028784538",
            "telephone_number": "401-624-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 MAIN RD",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028784538",
            "telephone_number": "401-624-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE BRIDGE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "BAZZONI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "401-624-2375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "1864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  BLUE SHIELD",
            "identifier": "8931-3",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern New England Wellness LLC
• Michelle Lynn Souza, LMT
• Keelyn A Spear, DS
• St Anne's Hospital (dbaTiverton Primary Care)
• Jillian St.Laurent, AS
• Charmian Talbot, MA, LADC1, LCDP
• Cynthia Maria Thomson, SLP,CCC
• Tiverton Counseling Services
• Tiverton Dental Associates
• Tiverton School Department

• General Practice Dentistry in Tiverton, RI
• Providers in Tiverton, RI by specialty
• General Practice Dentistry in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.