NPIMap

Organization Active NPI

Altieri Dental,PC

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1578710398
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16950 Issued in TX
Legal business name
ALTIERI DENTAL,PC
Practice address
5521 Bellaire Dr S
Suite202
Fort Worth, TX 76109-8838
Phone
(817) 294-5513
NPI assigned
Aug 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Authorized official

Name
Dr. Kevin M Altieri, DDSNPI 1003967068
Title
President/ Dentist
Phone
(817) 294-5513

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 16950 TX Primary

Addresses

Primary practice location

5521 Bellaire Dr S
Suite202
Fort Worth, TX 76109-8838

Mailing address

5521 Bellaire Dr S
Suite202
Fort Worth, TX 76109-8838
Phone (817) 294-5513

Other identifiers 2

IdentifierTypeStateIssuer
157688601MedicaidTX
091186903MedicaidTX

National Provider Directory

National Provider Directory

Locations

5521 Bellaire Dr S
Ste 202
Fort Worth, TX 76109
Phone (817) 294-5513

Practitioners & affiliated clinicians

Practitioners 2

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": "1219363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1578710398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5521 BELLAIRE DR S",
            "address_2": "SUITE202",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761098838",
            "telephone_number": "817-294-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 BELLAIRE DR S",
            "address_2": "SUITE202",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761098838",
            "telephone_number": "817-294-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTIERI DENTAL,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-22",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "ALTIERI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/ DENTIST",
        "authorized_official_telephone_number": "817-294-5513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157688601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091186903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.