Active NPI
Bahaa Rizkalla, D.D.S.
- General Practice Dentistry
- Plymouth, MA
National Provider Identifier
1083639223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12930
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12930 | 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
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38120 | Other | MA | HARVARD PILGRIM |
| X11381 | Other | MA | BLU CROSS OF MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12930 | MA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Practice Dentistry
- Plymouth, MA
- NPI 1437278314
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": "1083639223",
"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": "BAHAA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"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": "12930",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "38120",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLU CROSS OF MA",
"identifier": "X11381",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.