MEDICARE: JOHN VERBEYST, DMD

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	1223G0001X	General Practice Dentistry	2315	RI

General Provider Information

NPI Number	:	1578818886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN VERBEYST, DMD

Provider Business Mailing Address
First Line	:	1051 TEN ROD RD
Second Line	:	UNIT # 5
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4193
Country	:	US
Telephone Number	:	401-295-5511
Fax Number	:	401-295-5418

Provider Business Practice Location Address
First Line	:	1051 TEN ROD RD
Second Line	:	UNIT # 5
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4193
Country	:	US
Telephone Number	:	401-295-5511
Fax Number	:	401-295-5418

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. JOHN W VERBEYST
Credential	:	DMD
Telephone Number	:	401-295-5511

Provider Enumeration Date	:	07/24/2012
Last Update Date	:	07/24/2012

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