Paul A Andreatta, D.D.S. P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

C5167 Issued in CO

Practice address

1723 E Main St
Trinidad, CO 81082-2017

Phone

(719) 846-4028

Fax

(719) 845-0097

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104825561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 E MAIN ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822017",
            "telephone_number": "719-846-4028",
            "fax_number": "719-845-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 E MAIN ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822017",
            "telephone_number": "719-846-4028",
            "fax_number": "719-845-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREATTA",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S. P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "C5167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adapthealth West, LLC (AdaptHealth)
• Aerocare Holdings, Inc.
• Bryannita Aiken
• American Electronic Solutions, Inc.
• Teresa Aragon, ABOC
• Anita Laverne Archibeque, M.A.
• Brandon G Baca, MSPT
• Heather M Baca, M.S.,ED.,CCC-SLP
• Jillian Maria Baca, SLPA

• General Practice Dentistry in Trinidad, CO
• Providers in Trinidad, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.