EAST BAY ORAL SURGERY (NPI# 1285692731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285692731 |
Entity Type | Organization |
Organization Name | EAST BAY ORAL SURGERY |
Practice Address |
2224 Pawtucket Avenue East Providence RI 02914 |
Practice Telephone | 4014354240 |
Practice Fax Number | 4014354245 |
Mailing Telephone | 4014354240 |
Mailing Fax Number | 4014354245 |
Enumeration Date | 2006-05-03 |
Last Update Date | 2008-04-20 |
Authorized Official Name | DR. STEPHEN NICHOLAS BAKIAS (OWNER) |
Authorized Official Telephone | 4014354240 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
16987 | MA | Dental Providers |
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1686 | RI | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MA | BLUE CROSS | X11644 | 01 |
RI | BLUE CROSS | 80301 | 01 |
Street Address |
2224 PAWTUCKET AVENUE |
City | EAST PROVIDENCE |
State | RI |
Zip Code | 02914 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457988198 | Sean C. Duffy | Massage Therapist | 231 Warren Ave., East Providence, RI 02914 | 2020-03-24 |
1457905606 | Jeanine Le-kreuzer, Lmhc | Clinic/Center | 3421 Pawtucket Ave, East Providence, RI 02914 | 2019-07-26 |
1881113983 | Megan Grace Fitzpatrick | Student in an Organized Health Care Education/Training Program | 51 Milburn Rd, East Providence, RI 02914 | 2017-09-11 |
1265719660 | Hilary Elise Bicknell | Physical Therapist | 927 B Warren Ave, East Providence, RI 02914 | 2011-11-14 |
1346549037 | Amanda M Hope | Occupational Therapist | 2680 Pawtucket Ave, East Providence, RI 02914 | 2011-03-21 |
1780993824 | Shannon Hayes | Physical Therapist | 400 Massaoit Ave, East Providence, RI 02914 | 2010-10-06 |
1053623538 | Ricardo Rafael Correa Marquez | Internal Medicine | 900 Warren Avenue, Suite 300, East Providence, RI 02914 | 2010-07-13 |
1013231570 | Michael Seidler | Internal Medicine | 20 Catamore Blvd., East Providence, RI 02914 | 2010-03-26 |
1053543405 | Ray Rezania | Dentist | 1055 South Broadway, East Providence, RI 02914 | 2009-08-19 |
1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
Find all providers in zip 02914 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902011174 | Stephen Nicholas Bakios | Dentist | 2224 Pawtucket Ave, East Providence, RI 02914-1716 | 2007-05-11 |
1760430730 | Anthony Rocco Petito | Dentist | 400 Massasoit Ave, Suite 103, East Providence, RI 02914-2012 | 2006-05-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093889800 | Drs Aschaffenburg & English Jr Ltd | Dentist | 222 Jefferson Boulevard, Suite 301, Warwick, RI 02888-3855 | 2006-11-20 |
1942300678 | Albert E. Carlotti Jr. | Dentist | 915 Oaklawn Ave, Cranston, RI 02920-2638 | 2006-09-23 |
1306942867 | Ri Dental Surgery & Implants, Ltd. | Dentist | 468 Smithfield Rd, North Providence, RI 02904-4238 | 2006-09-15 |
1356359046 | Joel H Harrison | Dentist | 230 Airport Rd, Warwick, RI 02889-1039 | 2006-08-04 |
1730193277 | Stephen T. Skoly Jr. | Dentist | 30 Chapel View Blvd., Suite 240, Cranston, RI 02920 | 2006-07-28 |
1700817384 | University Oral & Maxillofacial Surgery Ltd | Dentist | 1370 S County Trl, East Greenwich, RI 02818-1625 | 2006-07-05 |
1578538088 | Steven H. Young | Dentist | 1414 Atwood Ave, Suite 340, Johnston, RI 02919-4839 | 2006-02-18 |
1245203793 | Luis Francisco Rosario | Dentist | 1173 Whipple Road, Branch Dental Clinic Newport, Newport, RI 02841 | 2006-02-07 |
1518939388 | Martin T Elson | Dentist | 1265 Reservoir Ave, Cranston, RI 02920-6060 | 2006-02-06 |
1588649644 | Brian P Hogan | Dentist | 65 W Main Rd, Middletown, RI 02842-4933 | 2005-12-13 |
Find all providers with the same taxonomy |
City | EAST PROVIDENCE |
Zip Code | 02914 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.