Healthcare Provider Details

I. General information

NPI: 1578090569
Provider Name (Legal Business Name): SALVATORE RIZZUTO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 EAST AVE
WESTERLY RI
02891-3113
US

IV. Provider business mailing address

79 RETREAT AVE
HARTFORD CT
06106-2527
US

V. Phone/Fax

Practice location:
  • Phone: 401-596-0319
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN03379
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: