Individual provider Active NPI

Susanne Yvonne Lavoie, DDS

  • General Practice Dentistry
  • Johnston, RI
National Provider Identifier
1982716064
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN02060 Issued in RI
Practice address
1481 Atwood Ave
Suite #3
Johnston, RI 02919-4800
Phone
(401) 228-7550
Fax
(401) 228-7560
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN02060 RI Primary

Addresses

Primary practice location

1481 Atwood Ave
Suite #3
Johnston, RI 02919-4800

Mailing address

1481 Atwood Ave
Suite #3
Johnston, RI 02919-4800
Phone (401) 228-7550

Other identifiers 1

IdentifierTypeStateIssuer
SL16727MedicaidRI

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1982716064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 ATWOOD AVE",
            "address_2": "SUITE #3",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029194800",
            "telephone_number": "401-228-7550",
            "fax_number": "401-228-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 ATWOOD AVE",
            "address_2": "SUITE #3",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029194800",
            "telephone_number": "401-228-7550",
            "fax_number": "401-228-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVOIE",
        "first_name": "SUSANNE",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN02060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SL16727",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.