Provider Demographics
NPI:1821460569
Name:BENEDICT J INGEGNERI JR DMD PC INC
Entity Type:Organization
Organization Name:BENEDICT J INGEGNERI JR DMD PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENEDICT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:INGEGNERI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-658-1888
Mailing Address - Street 1:3231 MENDON RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-2459
Mailing Address - Country:US
Mailing Address - Phone:401-658-1888
Mailing Address - Fax:
Practice Address - Street 1:3231 MENDON RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-2459
Practice Address - Country:US
Practice Address - Phone:401-658-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN2497122300000X
RIDEN3227122300000X
RIDEN17541223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty