Wickford Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

RI002894 Issued in RI

Legal business name

WICKFORD ORTHODONTICS

Practice address

320 Phillips St
Suite 202
North Kingstown, RI 02852-5149

Phone

(401) 295-2700

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Kelley Radtke

Title

Office Manager

Phone

(401) 295-2700

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Staci Chantelle Paletta, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Raynham, MA
  • NPI 1861418063
  NPD (past)

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891997490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PHILLIPS ST",
            "address_2": "SUITE 202",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028525149",
            "telephone_number": "401-295-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 PHILLIPS ST",
            "address_2": "SUITE 202",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028525149",
            "telephone_number": "401-295-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKFORD ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RADTKE",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "401-295-2700"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "RI",
            "license": "RI002894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW60095",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WO60094",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald J White
• Wickford Family Medicine LLC
• Wickford Family Practice LLC
• Wickford Internists, Inc.
• Wickford Optical, LLC
• Wickford Orthodontics, LLC
• Jennifer Susan Wilkinson Shepherd, M.S.
• Peter Wilkinson, APRN, NP-C
• Sharnese K Williams
• Mackenzie Wolk, LMHCA

• Orthodontics and Dentofacial Orthopedics Dentistry in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.