Active NPI
Alan Rissolo, M.D
- Oral and Maxillofacial Surgery (Dentist)
- Norwalk, CT
National Provider Identifier
1528082278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 007285
- Practice address
- 10 Mott Ave
Norwalk, CT 06850-3320 - Phone
- (203) 853-0500
- Fax
- (203) 853-0501
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 007285 | CT | Primary |
Addresses
Primary practice location
10 Mott Ave
Norwalk, CT 06850-3320
Mailing address
10 Mott Ave
Norwalk, CT 06850-3320
Phone (203) 853-0500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 18, 2024 through Jan 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528082278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 MOTT AVE",
"city": "NORWALK",
"state": "CT",
"postal_code": "068503320",
"telephone_number": "203-853-0500",
"fax_number": "203-853-0501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 MOTT AVE",
"city": "NORWALK",
"state": "CT",
"postal_code": "068503320",
"telephone_number": "203-853-0500",
"fax_number": "203-853-0501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISSOLO",
"first_name": "ALAN",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CT",
"license": "007285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CT
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.