Mary Grace Rizzo, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS039950 Issued in PA

Practice address

105 W 9TH St
Berwick, PA 18603-3024

Phone

(570) 752-4542

Fax

(570) 752-6806

NPI assigned

Jun 2, 2014

Sex

Female

Sole proprietor

No

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.

• Berwick Dental Arts Inc

  • General Practice Dentistry
  • Berwick, PA
  • NPI 1104906650

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 2, 2014.

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1477965945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W 9TH ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186033024",
            "telephone_number": "570-752-4542",
            "fax_number": "570-752-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 9TH ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186033024",
            "telephone_number": "570-752-4542",
            "fax_number": "570-752-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZZO",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resilient Mind Mental Health LLC
• Resurgent Life
• Annalouise Rivenbark
• Virginia Sue Rivenbark, CD
• Riverhealth L.L.C
• Verona D Roberts, CRNP
• Robert A. Rodman, DC
• Mark Edward Rongone, DDS
• Chelsea Schwartz
• Jason Scotti, M.D.

• All providers in Berwick, PA
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.