Healthcare Provider Details

I. General information

NPI: 1922893957
Provider Name (Legal Business Name): DEREK STEPHEN RIZZITELLI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 CHERRY ST
MILFORD CT
06460-3501
US

IV. Provider business mailing address

26 PRINDLE AVE
DERBY CT
06418-2049
US

V. Phone/Fax

Practice location:
  • Phone: 475-271-4561
  • Fax:
Mailing address:
  • Phone: 203-997-1435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14696
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: