Provider Demographics
NPI:1558083451
Name:JESSICA LANGELLA DMD, LLC
Entity Type:Organization
Organization Name:JESSICA LANGELLA DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-524-8421
Mailing Address - Street 1:24 SALT POND RD STE G2
Mailing Address - Street 2:
Mailing Address - City:SOUTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02879-4325
Mailing Address - Country:US
Mailing Address - Phone:401-648-4989
Mailing Address - Fax:
Practice Address - Street 1:24 SALT POND RD STE G2
Practice Address - Street 2:
Practice Address - City:SOUTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02879-4325
Practice Address - Country:US
Practice Address - Phone:401-648-4989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDEN03604OtherDENTIST