Matthew Palazzolo, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN014720 Issued in GA

Practice address

8354 Rose Ridge Dr NE
Rockford, MI 49341-8844

Phone

(616) 901-9244

NPI assigned

Sep 12, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 22, 2016 through Jan 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lea Endodontics, Inc

  • Endodontics
  • Richmond Hill, GA
  • NPI 1225432040
  NPD (past)

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1912156019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8354 ROSE RIDGE DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418844",
            "telephone_number": "616-901-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8354 ROSE RIDGE DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418844",
            "telephone_number": "616-901-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZOLO",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-12",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN014720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Warren Olthoff, MSW
• One Day Niche
• Jose Luis Orozco Jr., LPC
• Addison Ouellette
• Addison Pahl
• Palm & Panek DDS PC
• Keltie Palmer, LPC
• Dorian Parent, CHIROPRACTOR
• Lauren Michelle Park
• Katherine Partyka, PT

• Endodontics in Rockford, MI
• Providers in Rockford, MI by specialty
• Endodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.