DR. DAVID ANTHONY PEZZULLO (NPI# 1831101989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831101989 |
| Entity Type | Individual |
| Full Name | DR. DAVID ANTHONY PEZZULLO |
| Credential | DMD |
| Practice Address |
400 Reservoir Ave Suite 3e Providence RI 02907 |
| Practice Telephone | 4017813393 |
| Practice Fax Number | 4017813408 |
| Mailing Telephone | 4017813393 |
| Mailing Fax Number | 4017813408 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DEN1851 | RI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174557367 | David J Pezzullo | Physical Therapist | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2006-07-11 |
| Street Address |
400 RESERVOIR AVE SUITE 3E |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538152822 | Kathleen Mary Melbourne | Pharmacist | 400 Reservoir Ave, Suite 1d Coastal Medical, Providence, RI 02907-3565 | 2005-08-23 |
| 1023481561 | The Wellness Center Ri, LLC | Community/Behavioral Health | 400 Reservoir Ave, Suite 2k, Providence, RI 02907-3565 | 2015-11-05 |
| 1053537464 | Cityline Dental Inc. | Dentist | 400 Reservoir Ave, Suite 3d, Providence, RI 02907-3565 | 2007-04-17 |
| 1053433730 | Haigh Ventures, Inc | Home Health | 400 Reservoir Ave, Suite Ll - J, Providence, RI 02907-3565 | 2007-04-04 |
| 1043345226 | Michael C Furia | Dentist | 400 Reservoir Ave, Suite 3d, Providence, RI 02907 | 2007-02-21 |
| 1073655379 | Coastal Medical, Inc. | Non-Pharmacy Dispensing Site | 400 Reservoir Ave, Providence, RI 02907-3565 | 2007-02-13 |
| 1326139023 | Capitol Home Care Network Inc | Home Health | 400 Reservoir Ave, Suite L-ln, Providence, RI 02907-3565 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518522861 | Catherine M Katzberg | Massage Therapist | Santosha Yoga Studio, 275 Reservoir Ave, Providence, RI 02907 | 2019-05-02 |
| 1104317007 | Victa LLC | Internal Medicine | 110 Elmwood Ave # A, Providence, RI 02907 | 2018-05-25 |
| 1639566987 | Southside Elementary Charter School | Local Education Agency (LEA) | 126 Somerset Street, Providence, RI 02907 | 2015-04-23 |
| 1063846558 | Achievement First Providence Mayoral Academy Charter School | Local Education Agency (LEA) | 370 Hartford Aveneue, Providence, RI 02907 | 2013-09-03 |
| 1912297425 | Reynaldo P Baduya Sr.,dmd | Clinic/Center | 252 Adelaide Avenue, Providence, RI 02907 | 2011-04-18 |
| 1821218587 | Map Behavioral Health Serv. Inc. | Community/Behavioral Health | 66 Burnett Street, Providence, RI 02907 | 2007-04-26 |
| 1548336944 | Angelica Redleaf | Chiropractor | 1196 Elmwood Avenue, Providence, RI 02907 | 2006-11-28 |
| 1174619878 | Emilio Rodriguez-peris | Internal Medicine | 655 Broad Street, Suite 201, Providence, RI 02907 | 2006-10-04 |
| 1841381555 | Maged Taman | Internal Medicine | 21 Peace Street, Providence, RI 02907 | 2006-09-27 |
| 1003924226 | Gladys V Rezendes | Psychologist | 118 Comstock Avenue, Providence, RI 02907 | 2006-08-28 |
| Find all providers in zip 02907 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225185747 | Steven Jay Peiser | Dentist | 324 Angell St, Providence, RI 02906-3205 | 2007-01-05 |
| 1639271554 | Jeffrey Bram Shapiro | Dentist | 189 Governor St, Providence, RI 02906 | 2006-09-01 |
| 1467465054 | Denise M Shapiro | Dentist | 40 Elmgrove Avenue, Providence, RI 02906 | 2006-08-14 |
| 1801206677 | Periodontal Associates, Ltd. | Dentist | 189 Governor St, Providence, RI 02906-3124 | 2014-05-02 |
| 1982810214 | Scott Mark Fertik | Dentist | 167 Gano St, Providence, RI 02906-3808 | 2007-05-15 |
| 1841403953 | John G. Broderick | Dentist | 167 Gano St, Providence, RI 02906-3808 | 2007-05-07 |
| 1205980604 | Donald Michael Kallio | Dentist | 16 Bridge St, Corliss Landing, Providence, RI 02903-4362 | 2007-01-22 |
| 1699828640 | Peter Payne | Dentist | 151 Waterman St, Providence, RI 02906-2118 | 2007-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124231253 | Daniel Peter Decesare | Dentist | 1740 Atwood Ave., Johnston, RI 02919-3269 | 2007-05-07 |
| 1447378047 | Perio Inc | Dentist | 118 Point Judith Road, Unit 3, Narragansett, RI 02882-3439 | 2007-03-26 |
| 1275666141 | George W Pirie | Dentist | 77 Toll Gate Road, Warwick, RI 02886-4443 | 2007-03-13 |
| 1851434070 | Gregory S Theberge | Dentist | 1740 Atwood Ave, Johnston, RI 02919-3214 | 2007-02-15 |
| 1508950924 | Martin Craig Nager | Dentist | 67 Jefferson Boulvard, Warwick, RI 02888-1053 | 2006-10-02 |
| 1265542955 | George B Gettinger | Dentist | 2138 Mendon Rd Ste 201, Cumberland, RI 02864-3835 | 2006-08-30 |
| 1801307319 | Giuseppe Cicero | Dentist | 130 Granite St, Westerly, RI 02891-2495 | 2017-10-24 |
| 1790105401 | George B. Gettinger, Dmd, Professional Corporation | Dentist | 2138 Mendon Rd, Suite 201, Cumberland, RI 02864-3834 | 2014-04-21 |
| 1265759567 | City Dental of Woonsocket, LLC | Dentist | 515 Social St, Woonsocket, RI 02895-2043 | 2010-04-26 |
| 1336398676 | Advanced Cosmetic Dentistry Ltd | Dentist | 1090 New London Ave, Cranston, RI 02920-3035 | 2008-09-11 |
| Find all providers with the same taxonomy | ||||
| City | PROVIDENCE |
| Zip Code | 02907 |
Please comment or provide details below to improve the information on DR. DAVID ANTHONY PEZZULLO.
| 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.