Provider Demographics
NPI:1417784984
Name:JOHNSTON FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:JOHNSTON FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-521-3661
Mailing Address - Street 1:1136 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-7111
Mailing Address - Country:US
Mailing Address - Phone:401-521-3661
Mailing Address - Fax:
Practice Address - Street 1:1136 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-7111
Practice Address - Country:US
Practice Address - Phone:401-521-3661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNSTON FAMILY DENTISTRY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty