Individual provider Active NPI

Jeffrey S Rizzo, DMD

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1790813772
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 15352 Issued in FL
Practice address
6150 Metrowest Blvd
#207
Orlando, FL 32835-3289
Phone
(407) 521-8765
Fax
(407) 521-0628
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 15352 FL Primary

Addresses

Primary practice location

6150 Metrowest Blvd
#207
Orlando, FL 32835-3289

Mailing address

6150 Metrowest Blvd
#207
Orlando, FL 32835-3289
Phone (407) 521-8765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20150706001522 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7618289638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 15352FLMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1790813772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 METROWEST BLVD",
            "address_2": "#207",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328353289",
            "telephone_number": "407-521-8765",
            "fax_number": "407-521-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 METROWEST BLVD",
            "address_2": "#207",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328353289",
            "telephone_number": "407-521-8765",
            "fax_number": "407-521-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZZO",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 15352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.