Active NPI
Patrick Lyn Wolfe, D.D.S.
- General Practice Dentistry
- Altoona, IA
National Provider Identifier
1497832968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 08211
- Practice address
- 125 24TH St SE
Altoona, IA 50009-2167 - Phone
- (515) 967-9790
- Fax
- (515) 967-1425
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 08211 | IA | Primary |
Addresses
Primary practice location
125 24TH St SE
Altoona, IA 50009-2167
Mailing address
1016 Rosewood Dr
Altoona, IA 50009-2490
Phone (515) 957-8396
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0481630 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08211 | IA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wolfe Family Dentistry Inc. | General Practice | Current | Accepting new patients |
Locations
125 24th St SE
Altoona, IA 50009
Phone (515) 967-9790
Organizations & group practices 1
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": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594598400000",
"number": "1497832968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 ROSEWOOD DR",
"city": "ALTOONA",
"state": "IA",
"postal_code": "500092490",
"telephone_number": "515-957-8396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 24TH ST SE",
"city": "ALTOONA",
"state": "IA",
"postal_code": "500092167",
"telephone_number": "515-967-9790",
"fax_number": "515-967-1425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFE",
"first_name": "PATRICK",
"middle_name": "LYN",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2020-07-13",
"certification_date": "2020-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "08211",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0481630",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Altoona, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.