Gary Gene Andreoletti, D.D.S.
Individual provider Active NPI General Practice Dentistry · Fruita, CO
NPI 1437132016 · NPPES record last updated Jul 8, 2009
Key facts
- NPI
- 1437132016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 104419 (CO)
- Practice address
- 576 Kokopelli Blvd
Suite B
Fruita, CO 81521-6304 - Phone
- (970) 858-4544
- Fax
- (970) 858-9187
- NPI assigned
- Nov 28, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151028002772 | CO | Order and Referring Only - Oral Surgery |
7719296946 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 104419 | CO | Yes |
Addresses
Primary practice location
576 Kokopelli Blvd
Suite B
Fruita, CO 81521-6304
Mailing address
576 Kokopelli Blvd
Suite B
Fruita, CO 81521-6304
Phone (970) 858-4544
Other providers in Fruita, CO
- Margaret Albers
- All About Home Care LLC
- Leslie Allen
- Erica Ammons
- Mary Ellen Anderson
- Ashoka Mind and Body LLC
- Shannon Auckly
- B & L Specialty Team
- Bellarae Home Care Agency, LLC
- Brian Knight Belnap
All providers in Fruita, CO · General Practice Dentistry in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.