Provider Demographics
NPI:1790813772
Name:RIZZO, JEFFREY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:RIZZO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 METROWEST BLVD
Mailing Address - Street 2:#207
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3289
Mailing Address - Country:US
Mailing Address - Phone:407-521-8765
Mailing Address - Fax:407-521-0628
Practice Address - Street 1:6150 METROWEST BLVD
Practice Address - Street 2:#207
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3289
Practice Address - Country:US
Practice Address - Phone:407-521-8765
Practice Address - Fax:407-521-0628
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 153521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice