Barrett Kyle Nordstrom, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DEN03481 Issued in RI

Practice address

1226 Hartford Ave Ste 101
Johnston, RI 02919-7100

Phone

(401) 331-7171

Fax

(401) 331-2755

NPI assigned

Feb 9, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 7, 2018 through Nov 7, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nordstrom Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Johnston, RI
  • NPI 1255041034
  NPD Authorized official
• McMillen Orthodontics LTD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Johnston, RI
  • NPI 1063433209
  NPD (past)
• Simply Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dayville, CT
  • NPI 1740675081
  NPD (past)

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1922499243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MAPLE AVE # 117",
            "city": "BARRINGTON",
            "state": "RI",
            "postal_code": "028063560",
            "telephone_number": "617-335-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 HARTFORD AVE STE 101",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029197100",
            "telephone_number": "401-331-7171",
            "fax_number": "401-331-2755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Main St Unit 33",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028183164",
            "country_code": "US",
            "telephone_number": "401-884-9650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORDSTROM",
        "first_name": "BARRETT",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-09",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "RI",
            "license": "DEN03481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Nicholas
• Angela Niles
• Tara Nimiroski, RN PRACTIONER
• Sara Nolette, M.A. CCC-SLP
• Nordstrom Orthodontics LLC
• Northwestern Ri Imaging Center, LLC
• Maritza Nunez, LMHC
• Amanda Nye
• Stephanie Lynn Nyzio
• Maria M O'Toole, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Johnston, RI
• Providers in Johnston, 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 Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.