Individual provider Active NPI

Karim Rizkalla, D.M.D.

  • General Practice Dentistry
  • Plymouth, MA
National Provider Identifier
1063437218
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20101 Issued in MA
Practice address
24 North St
Plymouth, MA 02360-3382
Phone
(508) 746-1840
Fax
(508) 746-7318
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20101 MA Primary

Addresses

Primary practice location

24 North St
Plymouth, MA 02360-3382

Mailing address

24 North St
Plymouth, MA 02360-3382
Phone (508) 746-1840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160405002455 MA Order and Referring Only - DentistPractitioner - Dentist 4284932385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20101MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rizkalla Dental Associates General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063437218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 NORTH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023603382",
            "telephone_number": "508-746-1840",
            "fax_number": "508-746-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NORTH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023603382",
            "telephone_number": "508-746-1840",
            "fax_number": "508-746-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZKALLA",
        "first_name": "KARIM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.