Alfonso Mawotee Dormu

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

66744 Issued in ND

Practice address

2703 14TH St W
West Fargo, ND 58078-8563

Phone

(701) 367-7111

NPI assigned

Sep 27, 2024

Last updated

Sep 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1841018074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 14TH ST W",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788563",
            "telephone_number": "701-367-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 14TH ST W",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788563",
            "telephone_number": "701-367-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMU",
        "first_name": "ALFONSO",
        "middle_name": "MAWOTEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "ND",
            "license": "66744",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Doerfler, MS, CCC/SLP
• Kingsley Dohnwana
• Audrey Dominguez
• Sanjuanita Dominguez
• Stacy Donahue
• Dezja Dotson
• Double Vision
• Taylor Douvier
• Cassandra Marie Doyle
• Dr. J Gregory Dye, P.C. (Family Vision)

• Nurse's Aide in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Nurse's Aide in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.