Richard H Carlson, D.D.S.

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Newport, RI

NPI 1871658005 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1871658005
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
1475 (RI)
Practice address
31 Long Wharf Mall
Newport, RI 02840-2906
Phone
(401) 846-9770
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1475RIMDOrthodontics and Dentofacial Orthopedic Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 1475 RI Yes

Addresses

Primary practice location

31 Long Wharf Mall
Newport, RI 02840-2906

Mailing address

31 Long Wharf Mall
Newport, RI 02840-2906
Phone (401) 846-9770

Other identifiers

IdentifierTypeStateIssuer
1475OtherRILISCENCE NUMBER

Other providers in Newport, RI

All providers in Newport, RI · Orthodontics and Dentofacial Orthopedics Dentistry in Rhode Island

Sources for this page

Verify at the official NPI Registry.