Walter Raymond Shaghalian

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN01534 Issued in RI

Practice address

1002 Pawtucket Ave
Rumford, RI 02916-1704

Phone

(401) 438-4964

Fax

(401) 434-6021

NPI assigned

Dec 16, 2005

Sex

Male

Sole proprietor

Yes

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

Enrolled in RI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Premier Care Dentistry of Rhode Island LLC

  dba Eric George DMD & Associates

  • Dentist
  • Coventry, RI
  • NPI 1780323618
  NPD (past)
• Shaghalian Family Dental, LLC

  • Dentist
  • Rumford, RI
  • NPI 1568904571
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942286497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 PAWTUCKET AVE",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029161704",
            "telephone_number": "401-438-4964",
            "fax_number": "401-434-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 PAWTUCKET AVE",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029161704",
            "telephone_number": "401-438-4964",
            "fax_number": "401-434-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAGHALIAN",
        "first_name": "WALTER",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN01534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maegan A Russo, BA, RBT
• Safe Nest Therapy and Consultation
• Vincent Joseph Seccareccia III, DVM
• Kristyn Sequeira, M.S
• Shaghalian Family Dental, LLC
• Chantal Aimee Shea, LICSW
• Oren Shtayermman
• Dawn E Souza, LPN
• Strength on My Side, Inc.
• Timothy Sullivan

• General Practice Dentistry in Rumford, RI
• Providers in Rumford, 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 Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.