Katina M. Alfieris, D.D.S.
Individual provider Active NPI General Practice Dentistry · Clovis, CA
NPI 1679734149 · NPPES record last updated Jun 18, 2008
Key facts
- NPI
- 1679734149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 41338 (CA)
- Practice address
- 1817 Shaw Ave Ste 101
Clovis, CA 93611-4069 - Phone
- (559) 325-1999
- Fax
- (559) 325-0999
- NPI assigned
- Jun 18, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20170627000327 | CA | Order and Referring Only - Dentist |
0749559268 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41338 | CA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 41338 | CA | Yes |
Addresses
Primary practice location
1817 Shaw Ave Ste 101
Clovis, CA 93611-4069
Mailing address
1817 Shaw Ave Ste 101
Clovis, CA 93611-4069
Phone (559) 325-1999
Other providers in Clovis, CA
- Carolyn Aldama
- Cassandra Aldaz
- Alex Y Hernandez, MD Inc
- Charles Alexander
- Reem Alferra
- Alfredo Lozano, LMFT
- Zeeshan Ali
- Vanessa Denise Alicea
- Jesse Adam Alifano
- Fatimah Aisha Allen
All providers in Clovis, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2008. 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.