DR. KATHRYN IRENE VITIELLO (NPI# 1619476058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619476058 |
| Entity Type | Individual |
| Full Name | DR. KATHRYN IRENE VITIELLO |
| Credential | DMD |
| Practice Address |
72 Woburn St Medford MA 02155-3419 |
| Practice Telephone | 7817102163 |
| Mailing Telephone | 7817102163 |
| Enumeration Date | 2018-02-11 |
| Last Update Date | 2018-02-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN15732 | MA | Dental Providers |
| Street Address |
72 WOBURN ST |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-3419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962777193 | Anne H Dennehy Dds | Dentist | 801 E Main St Ste 101, Medford, OR 97504-7169 | 2012-03-21 |
| 1164567624 | Scott Louis Goldstein | Dentist | 1719 N Ocean Ave Ste C, Medford, NY 11763-2669 | 2007-02-21 |
| 1306945381 | Pamela J Ortiz | Dentist | 691 Murphy Rd Suite 210, Medford, OR 97504 | 2006-09-22 |
| 1932199163 | David M Alex | Dentist | 1291 E Mcandrews Rd, Medford, OR 97504-6103 | 2005-10-27 |
| 1356334254 | Steven Alan Frimkess | Dentist | 1150 Crater Lake Ave, Suite C, Medford, OR 97504-6213 | 2005-08-25 |
| 1427058296 | Anne Heubach Dennehy | Dentist | 801 E Main St, Suite 101, Medford, OR 97504-7169 | 2005-07-22 |
| 1598262818 | James Kolby Robinson, Dmd | Dentist | 1291 E Mcandrews Rd, Medford, OR 97504-6103 | 2018-04-12 |
| 1154711687 | David M Alex Dds PC | Dentist | 1291 E Mcandrews Rd, Medford, OR 97504-6103 | 2015-02-05 |
| 1396085221 | Bren Dixon Dmd LLC | Dentist | 1150 Crater Lake Ave, Suite C, Medford, OR 97504-6213 | 2013-03-01 |
| 1114200912 | Medford Children's Dental Center, PC | Dentist | 520 Stokes Rd, Suite B 18, Medford, NJ 08055-2904 | 2011-09-28 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.