Active NPI
Katie M Coniglio, DDS
- Dentist
- Colleyville, TX
National Provider Identifier
1639307051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24577
- Practice address
- 5110 Heritage Ave
Colleyville, TX 76034-5910 - Phone
- (817) 318-5600
- Fax
- (817) 354-1210
- NPI assigned
- Jun 24, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 24577 | TX | Primary |
Addresses
Primary practice location
5110 Heritage Ave
Colleyville, TX 76034-5910
Mailing address
5110 Heritage Avenue
Colleyville, TX 76034
Phone (817) 318-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161107001704 | TX | Order and Referring Only - Dentist | 9133408529 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24577 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245801600000",
"number": "1639307051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5110 HERITAGE AVENUE",
"city": "COLLEYVILLE",
"state": "TX",
"postal_code": "76034",
"telephone_number": "817-318-5600",
"fax_number": "817-354-1210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5110 HERITAGE AVE",
"city": "COLLEYVILLE",
"state": "TX",
"postal_code": "760345910",
"telephone_number": "817-318-5600",
"fax_number": "817-354-1210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONIGLIO",
"first_name": "KATIE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-24",
"last_updated": "2009-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "24577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colleyville, TX
- Colleyville Vision Associates
- Josana Elizabeth Collins, PA-C
- Colverse Iom LLC
- Compass Youth and Family Psychological Services LLC
- Concord Anesthesia Services PLLC
- Jeffrey Alan Connors, D.C.
- Consulting Psychologists
- Stephanie Cook, LPC
- Cornerstone Health and Wellness PLLC
- Candace Cortez, BA IN FAMILY STUDIES
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.