Active NPIIndividual provider

Dr. Scott M Fertik, DDS

Dentist, Periodontics in Providence, Rhode Island

NPI Number1982810214
Practice location
167 Gano St, Providence, RI 02906-3808
Fax
401-421-7875
Last updated
July 8, 2007

Scott Mark Fertik is a Dentist, Periodontics based in Providence, RI. Scott Mark Fertik practices in Providence, RI and has the professional credentials of DDS. The NPI Number for Scott Mark Fertik is 1982810214 and holds a License No. DEN02345 (RI). The current practice location address for Scott Mark Fertik is 167 Gano St, Providence, RI 02906-3808 and can be reached out via phone at 401-274-2600 and via fax at 401-421-7875.

Provider Profile Details

NPI Number
1982810214
Provider Name
Scott Mark Fertik
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
167 Gano St, Providence, RI 02906-3808
Phone Number
401-274-2600
Fax Number
401-421-7875
Primary Taxonomy
Dentist, Periodontics · 1223P0300X
Sole Proprietor
No
Provider Enumeration Date
May 15, 2007
Last Update Date
July 8, 2007
NPI Status
Active

Provider Business Practice Location Address Details

Address
167 Gano St
Providence, RI 02906-3808
Zip
02906-3808
Phone Number
401-274-2600
Fax Number
401-421-7875
Providence, RI 02906Get directions →

Provider Business Mailing Address Details

Address
55 Signal Ridge Way
E Greenwich, RI 02818-1649
City
E Greenwich
State
RI
Zip
02818-1649
Phone Number
401-886-7999
Fax Number
401-421-7875

License Information

License Number
DEN02345
License State
RI
Taxonomy
Dentist, Periodontics · 1223P0300X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

Other Dentist, Periodontics providers near Providence, RI

View all Dentist, Periodontics providers in Providence →

Frequently Asked Questions

What is the NPI number of Dr. Scott M Fertik, DDS?

The NPI number of Dr. Scott M Fertik, DDS is 1982810214. It was assigned on May 15, 2007 and is currently active in the NPPES registry.

What is the specialty of Dr. Scott M Fertik, DDS?

Dr. Scott M Fertik, DDS is registered under the primary taxonomy Dentist, Periodontics (code 1223P0300X), licensed in RI under license number DEN02345.

Where does Dr. Scott M Fertik, DDS practice?

The practice location is 167 Gano St, Providence, RI 02906-3808. The office can be reached at 401-274-2600 (phone) or 401-421-7875 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1982810214 directly on the NPPES registry website.

Browse related providers