Lisa Gabrius Fortunato

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5427 Issued in WI

Practice address

6218 Washington Ave
Suite C
Racine, WI 53406-3916

Phone

(262) 886-1300

Fax

(262) 886-1837

NPI assigned

Dec 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275699738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6218 WASHINGTON AVE",
            "address_2": "SUITE C",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063916",
            "telephone_number": "262-886-1300",
            "fax_number": "262-886-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6218 WASHINGTON AVE",
            "address_2": "SUITE C",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063916",
            "telephone_number": "262-886-1300",
            "fax_number": "262-886-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIUS FORTUNATO",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Friedrich, MT-BC
• Patricia S Friss
• Kara L Froman, M.S., CCC
• Peg Gabik, LPC
• Rebecca Lynn Gabower, PTA
• Janice Gaeth
• Jan Gainer
• David Galbis-Reig, M.D.
• Mary Ann Galligan-Habermehl
• Marissa Lynn Gallo, PHARMD

• General Practice Dentistry in Racine, WI
• Providers in Racine, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.