Jason Roger Izzi, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2581 Issued in RI

Practice address

1351 Smith St
North Providence, RI 02911-3340

Phone

(401) 353-2045

Fax

(401) 354-8488

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1477576106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 SMITH ST",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029113340",
            "telephone_number": "401-353-2045",
            "fax_number": "401-354-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 SMITH ST",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029113340",
            "telephone_number": "401-353-2045",
            "fax_number": "401-354-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZI",
        "first_name": "JASON",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "RI",
            "license": "2581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8761-8",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JI27223",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inpatient Medical Associates of Providence LLC
• Integrity Sleep Care, LLC
• Internal Medicine Endocrinology Assoc, Inc
• Internal Medicine Partners, Inc
• Isd Renal Inc
• Teresa Lorena Jeraldo, M.D.
• Joseph a. Izzi M.D., Inc.
• Glenda Kaija
• Jillian Karno
• Marissa Nicole Keighley

• Orthodontics and Dentofacial Orthopedics Dentistry in North Providence, RI
• Providers in North Providence, RI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.