Provider Demographics
NPI:1598244360
Name:PIZZO, KATELYN CASS (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:CASS
Last Name:PIZZO
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 DON DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3108
Mailing Address - Country:US
Mailing Address - Phone:716-338-6722
Mailing Address - Fax:
Practice Address - Street 1:4207 E NORTH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2422
Practice Address - Country:US
Practice Address - Phone:864-774-5601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-12
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11122122300000X
SC98651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist