Individual provider Active NPI

Emmanuel Antonio Frias, DDS

  • Dentist
  • Central Falls, RI
National Provider Identifier
1972697639
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049230-1 Issued in NY
Practice address
1044 Broad St
Central Falls, RI 02863-1507
Phone
(401) 722-4086
Fax
(401) 475-1875
NPI assigned
Oct 3, 2006
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 049230-1 NY Primary

Addresses

Primary practice location

1044 Broad St
Central Falls, RI 02863-1507

Mailing address

15 Firethorn LN
Cranston, RI 02920-3710
Phone (347) 683-0041

Other identifiers 2

IdentifierTypeStateIssuer
9176819OtherNYDORAL OFFICE LOCATION
02145751MedicaidNY

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
049230-1NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Blackstone Dental,PC Dentist Current Accepting new patients

Locations

1044 Broad St
Central Falls, RI 02863
Phone (401) 722-4086

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1972697639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FIRETHORN LN",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029203710",
            "telephone_number": "347-683-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BROAD ST",
            "city": "CENTRAL FALLS",
            "state": "RI",
            "postal_code": "028631507",
            "telephone_number": "401-722-4086",
            "fax_number": "401-475-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIAS",
        "first_name": "EMMANUEL",
        "middle_name": "ANTONIO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049230-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL OFFICE LOCATION",
            "identifier": "9176819",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02145751",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Falls, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.