MEDICARE: DR. CALVIN J PIERCE DMD PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	RI 647	RI
2	1223G0001X	General Practice Dentistry	DEN02620	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	87494	OTHER	RI	BCBS OF RI

General Provider Information

NPI Number	:	1063542520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CALVIN J PIERCE DMD PHD

Provider Business Mailing Address
First Line	:	145 PHILLIPS ST
Second Line	:	CALVIN J PIERCE DMD PHD
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-5179
Country	:	US
Telephone Number	:	401-294-4315
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 PHILLIPS STREET
Second Line	:
City	:	NO KINGSTOWN
State	:	RI
Zip	:	02852-5179
Country	:	US
Telephone Number	:	401-294-4315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	09/11/2025

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