DR. WALTER MATTHEW DZIALO (NPI# 1487752432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487752432 |
| Entity Type | Individual |
| Full Name | DR. WALTER MATTHEW DZIALO |
| Credential | D.D.S. |
| Practice Address |
526 Newport Ave Pawtucket RI 02861-3612 |
| Mailing Address |
37 Tashmoo Way Pawtucket RI 02861-3712 |
| Practice Telephone | 4017242570 |
| Practice Fax Number | 4017240199 |
| Mailing Telephone | 4017254465 |
| Mailing Fax Number | 4017250158 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
14966 | MA | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DEN01869 | RI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | WD00135 | 05 |
| Street Address |
526 NEWPORT AVE |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02861-3612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629525209 | Brianna Laurila | Dietitian, Registered | 541 Cottage Street, Pawtucket, RI 02861 | 2016-09-01 |
| 1790056430 | Matthew J Lavoie | Physician Assistant | 70 Gill Ave., Pawtucket Center, Genesis Health Care, Pawtucket, RI 02861 | 2012-01-25 |
| 1356359293 | Anita N Vasvani | Dentist | 140 Newport Ave, Pawtucket, RI 02861 | 2006-08-04 |
| 1548294408 | Stop and Shop Supermarket Co LLC | Pharmacy | 368398 Cottage Street, Pawtucket, RI 02861 | 2006-07-10 |
| 1154363695 | Levis M Guzman | Internal Medicine | 139 Benefit St, Pawtucket, RI 02861 | 2006-06-11 |
| 1265938179 | Modern Eyes LLC | Optometrist | 145 Newport Ave, Pawtucket, RI 02861 | 2018-04-01 |
| 1942313929 | Abbas Ghorieshi | Dentist | 115 Newport Ave, Pawtucket, RI 02861 | 2006-08-16 |
| 1114499506 | Arts, Sports, and Technology Resource Organization | Poetry Therapist | 175 Coyle Ave, Pawtucket, RI 02861-1007 | 2018-12-22 |
| 1235600255 | Abdoulaye Soumahoro | Driver | 68 Webster St, Pawtucket, RI 02861-1016 | 2018-12-17 |
| 1376761544 | Professional Internal Medicine Associates Inc | Internal Medicine | 139 Benefit St, Pawtucket, RI 02861-1024 | 2007-04-23 |
| Find all providers in zip 02861 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639297351 | Howard Marcus Vincent | Dentist | 719 Armistice Blvd, Pawtucket, RI 02861-2746 | 2007-03-27 |
| 1649310988 | Raj Venkat Dulala | Dentist | 1571 Newport Ave, Suite2, Pawtucket, RI 02861-1351 | 2007-02-07 |
| 1891846374 | Pedro Luis Teixeira Sr. | Dentist | 176 Newport Ave, Pawtucket, RI 02861-4110 | 2007-01-13 |
| 1114076817 | Paul G. Roque | Dentist | 642 Newport Ave, Pawtucket, RI 02861-3238 | 2007-01-10 |
| 1700941499 | Eglantina Kica | Dentist | 388 Armistice Blvd, Pawtucket, RI 02861-2452 | 2006-12-24 |
| 1861585333 | John Verbeyst | Dentist | 407 Smithfield Ave, Pawtucket, RI 02860 | 2006-10-02 |
| 1942391297 | Philip J Calabro | Dentist | 500 Newport Ave, Pawtucket, RI 02861-3612 | 2006-09-28 |
| 1043231541 | Gerard Arthur Belhumeur | Dentist | 629 Central Ave, Pawtucket, RI 02861-1955 | 2006-07-21 |
| 1093735524 | Dimitri George Ganim | Dentist | 878 Newport Ave, Pawtucket, RI 02861-2642 | 2006-07-20 |
| 1417910696 | Russell Soy Chin | Dentist | 1288 Newport Ave, Pawtucket, RI 02861-1851 | 2006-04-10 |
| Find all providers in PAWTUCKET | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.