NPIMap

Organization Active NPI

Dr. Rico Bertagnolli Family Dentistry,P.C.

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1962661256
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7377 Issued in IA
Legal business name
DR. RICO BERTAGNOLLI FAMILY DENTISTRY,P.C.
Practice address
921 E 23Rd St
Des Moines, IA 50317-6515
Phone
(515) 262-9581
NPI assigned
Jun 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Dr. Rico L Bertagnolli, D.D.S.NPI 1699855254
Title
Dentist
Phone
(515) 262-9581

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 7377 IA Primary

Addresses

Primary practice location

921 E 23Rd St
Des Moines, IA 50317-6515

Mailing address

921 E 23Rd St
Des Moines, IA 50317-6515
Phone (515) 262-9581

Other identifiers 1

IdentifierTypeStateIssuer
1699855254MedicaidIA

National Provider Directory

National Provider Directory

Locations

921 E 23rd St
Des Moines, IA 50317
Phone (515) 262-9581

Practitioners & affiliated clinicians

Practitioners 1

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": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1962661256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E 23RD ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503176515",
            "telephone_number": "515-262-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 E 23RD ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503176515",
            "telephone_number": "515-262-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RICO BERTAGNOLLI FAMILY DENTISTRY,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "BERTAGNOLLI",
        "authorized_official_first_name": "RICO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "515-262-9581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699855254",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.