Provider Demographics
NPI:1578818886
Name:JOHN VERBEYST, DMD
Entity Type:Organization
Organization Name:JOHN VERBEYST, DMD
Other - Org Name:JV CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:VERBEYST
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-295-5511
Mailing Address - Street 1:1051 TEN ROD RD
Mailing Address - Street 2:UNIT # 5
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4193
Mailing Address - Country:US
Mailing Address - Phone:401-295-5511
Mailing Address - Fax:401-295-5418
Practice Address - Street 1:1051 TEN ROD RD
Practice Address - Street 2:UNIT # 5
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4193
Practice Address - Country:US
Practice Address - Phone:401-295-5511
Practice Address - Fax:401-295-5418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI23151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty