Individual provider Active NPI

Maria Angelica Prieto Cavalieri

  • Dentist
  • Tomball, TX
National Provider Identifier
1366051658
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
FF88 Issued in MN
Practice address
12303 Spellbrook Point LN
Tomball, TX 77377-1740
Phone
(281) 797-2377
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X FL61 MN
Dentist 122300000X FF88 MN Primary

Addresses

Primary practice location

12303 Spellbrook Point LN
Tomball, TX 77377-1740

Mailing address

7454 Cahill Rd
Edina, MN 55439-2728
Phone (281) 797-2377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20240705001795 MN Practitioner - Dentist 7911441605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FF88MNMDDentist
FL61MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota CurrentSince Jun 21, 2024 Accepting new patients
Regents of the University of Minnesota CurrentSince Jun 21, 2024 Accepting new patients

Locations

2001 Bloomington Ave
Minneapolis, MN 55404
Phone (612) 301-3433

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1366051658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7454 CAHILL RD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392728",
            "telephone_number": "281-797-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 SPELLBROOK POINT LN",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773771740",
            "telephone_number": "281-797-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIETO CAVALIERI",
        "first_name": "MARIA",
        "middle_name": "ANGELICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "FL61",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "FF88",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

Verify at the official NPI Registry.