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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KHOHLIA MACK DMD
NPI 1245856590
Dentist in Providence, RI

Active since June 23, 2020PECOS Enrolled
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-4098 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 22, 2026, Jun 23, 2020 (2 updates tracked since 2020).

About Khohlia Mack Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KHOHLIA MACK DMD (NPI 1245856590) is an individual dentist in Providence, Rhode Island, licensed in Rhode Island (LD00178) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245856590
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameKHOHLIA MACKCredential: DMD
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 444-4098
Phone(401) 444-4098
Sole ProprietorYes
Enumeration DateJune 23, 2020
Last NPPES UpdateJuly 22, 20262 updates tracked since enumeration
NPPES CertifiedJuly 22, 2026
✔ NPI 1245856590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in RI · LD00178
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
593 EDDY ST, Providence, RI 02903
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Khohlia Mack Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02903 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRIAN CAO MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-4286
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Khohlia Mack's NPI number?

The NPI number for Khohlia Mack is 1245856590. It was assigned to this individual provider in the NPPES registry on June 23, 2020.

Where is Khohlia Mack located?

Khohlia Mack practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-4098.

What is Khohlia Mack's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Khohlia Mack enrolled in Medicare?

Yes. Khohlia Mack is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Khohlia Mack was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.