Organization Active NPI

Fred W. Salvatoriello DMD PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hanover, NH
National Provider Identifier
1396769733
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
016-0001165 Issued in VT
Legal business name
FRED W. SALVATORIELLO DMD PA
Practice address
3 Summer St
Hanover, NH 03755-2121
Phone
(603) 643-2170
Fax
(603) 643-2176
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Fred William Salvatoriello, DMDNPI 1760513782
Title
President
Phone
(603) 643-2170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 016-0001165 VT Primary

Addresses

Primary practice location

3 Summer St
Hanover, NH 03755-2121

Mailing address

3 Summer St
Hanover, NH 03755-2121
Phone (603) 643-2170

Other identifiers 2

IdentifierTypeStateIssuer
89191878MedicaidNH
0001878MedicaidVT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396769733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SUMMER ST",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037552121",
            "telephone_number": "603-643-2170",
            "fax_number": "603-643-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SUMMER ST",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037552121",
            "telephone_number": "603-643-2170",
            "fax_number": "603-643-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED W. SALVATORIELLO DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALVATORIELLO",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-643-2170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VT",
            "license": "016-0001165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89191878",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001878",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.