Healthcare Provider Details

I. General information

NPI: 1700699311
Provider Name (Legal Business Name): GREGORY CHARLES SHNITKIND DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 CRESTVIEW DR
WESTERLY RI
02891-2958
US

IV. Provider business mailing address

31 CRESTVIEW DR
WESTERLY RI
02891-2958
US

V. Phone/Fax

Practice location:
  • Phone: 401-596-7734
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN03870
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: