Active NPI
James Patrick Fortunato, D.D.S.
- Dentist
- Carson City, NV
National Provider Identifier
1174721476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4072
- Practice address
- 917 Mountain St
Carson City, NV 89703-3819 - Phone
- (775) 888-6887
- NPI assigned
- Jul 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4072 | NV | Primary |
| Dentist | 122300000X | 36363 | CA |
Addresses
Primary practice location
917 Mountain St
Carson City, NV 89703-3819
Mailing address
917 Mountain St
Carson City, NV 89703-3819
Phone (775) 888-6887
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36363 | CA | MD | Marriage & Family Therapist |
| 4072 | NV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308182400000",
"number": "1174721476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 MOUNTAIN ST",
"city": "CARSON CITY",
"state": "NV",
"postal_code": "897033819",
"telephone_number": "775-888-6887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 MOUNTAIN ST",
"city": "CARSON CITY",
"state": "NV",
"postal_code": "897033819",
"telephone_number": "775-888-6887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNATO",
"first_name": "JAMES",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-07",
"last_updated": "2011-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "4072",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "36363",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carson City, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.