Provider Demographics
NPI:1184739732
Name:MERJIK, RAFFI (DMD)
Entity type:Individual
Prefix:MR
First Name:RAFFI
Middle Name:
Last Name:MERJIK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HARTFORD PIKE
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1865
Mailing Address - Country:US
Mailing Address - Phone:401-934-2666
Mailing Address - Fax:401-934-2674
Practice Address - Street 1:26 HARTFORD PIKE
Practice Address - Street 2:
Practice Address - City:NORTH SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1865
Practice Address - Country:US
Practice Address - Phone:401-934-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0201642OtherMASS HEALTH PROVIDES #