Adam Altdorfer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00203463 Issued in CO

Practice address

1933 28TH St Ste 204
Boulder, CO 80301-1100

Phone

(720) 645-1226

NPI assigned

May 31, 2017

Last updated

Mar 5, 2021By the provider in NPPES

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 OH, CO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Experience Dental 3 PLLC

  • General Practice Dentistry
  • Fort Collins, CO
  • NPI 1134098718
  NPD Authorized official
• Sleep Better Apnea Therapy

  • Durable Medical Equipment & Medical Supplies
  • Boulder, CO
  • NPI 1578263679
  NPD Authorized official
• Experience Dental PLLC

  • Dental Clinic/Center
  • Boulder, CO
  • NPI 1013568963
  NPD

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1235667494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1482 MICHIGAN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 28TH ST STE 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011100",
            "telephone_number": "720-645-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTDORFER",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00203463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alpine Surgical LLC
• Alpine Urology, PLLC
• Alpine Woods Medical, PLLC
• Brooke Alt, M.D.
• Alta Physical Therapy PC
• Jeremy Richard Altdorfer, DDS
• Alison Kate Alter, FNP
• Elaine Alterman
• Alternative Health Clinic, PC
• Travis Althouse

• General Practice Dentistry in Boulder, CO
• Providers in Boulder, 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 Mar 5, 2021; 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.