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Colorado Dental Professionals, LLC

Organization Active NPI General Practice Dentistry · Colorado Springs, CO

NPI 1003555822 · NPPES record last updated May 31, 2022

Key facts

NPI
1003555822
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Practice address
745 W Baptist Rd
Colorado Springs, CO 80921-2454
Phone
(719) 203-7375
NPI assigned
May 31, 2022
Organization subpart
Yes
Parent organization (as reported)
COLORADO DENTAL PROFESSIONALS, LLC

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Corporate family (same tax ID) 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

National Provider Directory

Tax ID family
Colorado Dental Professionals LLC (44 organizations share this tax ID)
Part of
Colorado Dental Professionals LLC

Locations

745 W Baptist Rd
Colorado Springs, CO 80921
Phone (719) 203-7375

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP		 1223G0001X Yes

Addresses

Primary practice location

745 W Baptist Rd
Colorado Springs, CO 80921-2454

Mailing address

745 W Baptist Rd
Colorado Springs, CO 80921-2454
Phone (719) 203-7375

Other names

  • Dental Care at Monument Ridge Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 31, 2022.

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1003555822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 W BAPTIST RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809212454",
            "telephone_number": "719-203-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 W BAPTIST RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809212454",
            "telephone_number": "719-203-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at Monument Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

All providers in Colorado Springs, CO · General Practice Dentistry in Colorado

Sources for this page

Verify at the official NPI Registry.