Active NPI
Kylie Zaccari, DMD
- General Practice Dentistry
- Cranston, RI
National Provider Identifier
1750068151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN03661
- Practice address
- 1280 Park Ave
Cranston, RI 02910-3033 - Phone
- (401) 943-0644
- NPI assigned
- Jun 28, 2023
- Sex
- Female
- Sole proprietor
- No
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 | DEN03661 | RI | Primary |
Addresses
Primary practice location
1280 Park Ave
Cranston, RI 02910-3033
Mailing address
1420 Park Ave # 1
Cranston, RI 02920-6634
Phone (316) 213-2820
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 |
|---|---|---|---|
| DEN03661 | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1750068151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 PARK AVE # 1",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029206634",
"telephone_number": "316-213-2820"
},
{
"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"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZACCARI",
"first_name": "KYLIE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-28",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "RI",
"license": "DEN03661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.