Active NPI
Joseph P. Matrullo, DMD
- General Practice Dentistry
- Cranston, RI
National Provider Identifier
1598821167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2839
- Practice address
- 1280 Park Ave
Cranston, RI 02910-3033 - Phone
- (401) 943-0644
- Fax
- (401) 943-3276
- NPI assigned
- Dec 28, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2839 | RI | Primary |
Addresses
Primary practice location
1280 Park Ave
Cranston, RI 02910-3033
Mailing address
1280 Park Ave
Cranston, RI 02910-3033
Phone (401) 943-0644
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2839 | RI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul J. Matrullo, DDS, PC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598821167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1280 PARK AVE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029103033",
"telephone_number": "401-943-0644",
"fax_number": "401-943-3276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1280 PARK AVE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029103033",
"telephone_number": "401-943-0644",
"fax_number": "401-943-3276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATRULLO",
"first_name": "JOSEPH",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "RI",
"license": "2839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
- Kimberly Masterson, LMHC
- David P. Mastrostefano, DMD
- Rena B Mate, M.D.
- Patricia Marie Mathews, PHARMACIST
- Karen R Mathewson, OTR/L,CHT
- Paul J. Matrullo, DDS
- John Esmat Matta, PHARMD
- Maxi Drug South LP (Rite Aid Pharmacy 10262)
- Maxi Drug South LP (Rite Aid Pharmacy 10250)
- Maxi Drug South LP (Rite Aid Pharmacy 10254)
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.