Paul Michael Fortunato, D.M.D., M.S., ABGD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6347 Issued in CT

Practice address

4102 Pinion Dr
10 Medical Grouup
Usaf Academy, CO 80840-2502

Phone

(719) 333-5592

NPI assigned

Jan 25, 2006

Last updated

Jul 7, 2008By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1396715165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "10 MEDICAL GROUUP",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "10 MEDICAL GROUUP",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNATO",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "credential": "D.M.D., M.S., ABGD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "6347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devlin James Farr, DO
• Jennifer Lynn Fawaz, RDH
• Zachary Fetterman, PHD
• Justin James Fleming, PTA
• Patrice Flynn
• Almon H. Foster
• Maryann M Fulton, NP
• Annette Susan Gablehouse, CRNA
• Steven Galvan, PSY.D.
• Kassia O Garfield, DPT

• General Practice Dentistry in Usaf Academy, CO
• Providers in Usaf Academy, 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 Jul 7, 2008; 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.