Ian Jacob Altobelli, DMD
Individual provider Active NPI Dentist · Vail, AZ
NPI 1154256121 · NPPES record last updated Jun 12, 2026
Key facts
- NPI
- 1154256121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D012863 (AZ)
- Practice address
- 13410 E Mary Ann Cleveland Way
Vail, AZ 85641-8613 - Phone
- (520) 316-0613
- NPI assigned
- Jun 12, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentists of Vail, LLP | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D012863 | AZ | Yes |
Addresses
Primary practice location
13410 E Mary Ann Cleveland Way
Vail, AZ 85641-8613
Mailing address
13410 E Mary Ann Cleveland Way
Vail, AZ 85641-8613
Phone (520) 316-0613
Other providers in Vail, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.