Active NPI
Ian James Paisley, D.D.S.
- General Practice Dentistry
- Brighton, CO
National Provider Identifier
1003983750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8690
- Practice address
- 4700 E Bromley LN Ste 201
Brighton, CO 80601-7821 - Phone
- (303) 659-0667
- Fax
- (303) 659-5247
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8690 | CO | Primary |
Addresses
Primary practice location
4700 E Bromley LN Ste 201
Brighton, CO 80601-7821
Mailing address
4700 E Bromley LN Ste 201
Brighton, CO 80601-7821
Phone (303) 659-0667
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70882860 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8690 | CO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kellogg-Paisley LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1003983750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 E BROMLEY LN STE 201",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "806017821",
"telephone_number": "303-659-0667",
"fax_number": "303-659-5247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 E BROMLEY LN STE 201",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "806017821",
"telephone_number": "303-659-0667",
"fax_number": "303-659-5247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAISLEY",
"first_name": "IAN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "8690",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "70882860",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brighton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.