Laura J Rizzo, DMD
Individual provider Active NPI Dentist · Coalport, PA
NPI 1508874587 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508874587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS029015L (PA)
- Practice address
- 549 Main Street
Coalport, PA 16627 - Phone
- (814) 672-4313
- Fax
- (814) 672-4313
- NPI assigned
- Aug 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160309000286 | PA | Order and Referring Only - Other (Physician) |
2466758016 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laura J Rizzo DMD PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS029015L | PA | Yes |
Addresses
Primary practice location
549 Main Street
Coalport, PA 16627
Mailing address
PO Box 374
549 Main Street
Coalport, PA 16627
Phone (814) 672-4313
Other providers in Coalport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.