Healthcare Provider Details

I. General information

NPI: 1194466052
Provider Name (Legal Business Name): HANNAH DEMERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 THURBER BLVD UNIT A
SMITHFIELD RI
02917-1826
US

IV. Provider business mailing address

2417 MCGUIRE BLVD
MC GUIRE AFB NJ
08641-5116
US

V. Phone/Fax

Practice location:
  • Phone: 401-231-7390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN03775
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN27013
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: