Provider Demographics
NPI:1043221476
Name:BARONE, NICHOLAS D (DDS)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:D
Last Name:BARONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 MINERAL SPRING AVENUE
Mailing Address - Street 2:
Mailing Address - City:N PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-7648
Mailing Address - Country:US
Mailing Address - Phone:401-353-1292
Mailing Address - Fax:401-353-5780
Practice Address - Street 1:1804 MINERAL SPRING AVENUE
Practice Address - Street 2:
Practice Address - City:N PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-7648
Practice Address - Country:US
Practice Address - Phone:401-353-1292
Practice Address - Fax:401-353-5780
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN17621223X0400X
MA135361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics