Provider Demographics
NPI:1760795793
Name:CATALLOZZI, NICHOLAS KENNETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:KENNETH
Last Name:CATALLOZZI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 LONG WHARF MALL
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2906
Mailing Address - Country:US
Mailing Address - Phone:401-846-4404
Mailing Address - Fax:401-846-8544
Practice Address - Street 1:37 LONG WHARF MALL
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2906
Practice Address - Country:US
Practice Address - Phone:401-846-4404
Practice Address - Fax:401-846-8544
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN03156122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist