NPIMap

Organization Active NPI

Colorado Dhca, Boulder, PLLC

Doing business as Dental Health of Boulder, PLLC

  • General Practice Dentistry
  • Boulder, CO
National Provider Identifier
1013052653
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
579 Issued in CO
Legal business name
COLORADO DHCA, BOULDER, PLLC
Doing business as
Dental Health of Boulder, PLLC
Practice address
2525 28TH St Unit 140
Boulder, CO 80301-1255
Phone
(303) 443-0070
Fax
(303) 443-0073
NPI assigned
Feb 21, 2007
Last updated
Jul 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Ande Wittenberg
Title
Manager
Phone
(303) 443-0070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 579 CO Primary

Addresses

Primary practice location

2525 28TH St Unit 140
Boulder, CO 80301-1255

Mailing address

2525 28TH St Unit 140
Boulder, CO 80301-1255
Phone (303) 443-0070

Other identifiers 1

IdentifierTypeStateIssuer
841525799OtherCOSPECIALTY

Other names 1

  • Dental Health of Boulder, PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

2525 28th St
Unit 140
Boulder, CO 80301
Phone (303) 443-0070

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1013052653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 28TH ST UNIT 140",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011255",
            "telephone_number": "303-443-0070",
            "fax_number": "303-443-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 28TH ST UNIT 140",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011255",
            "telephone_number": "303-443-0070",
            "fax_number": "303-443-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DHCA, BOULDER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "WITTENBERG",
        "authorized_official_first_name": "ANDE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "303-443-0070"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIALTY",
            "identifier": "841525799",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Health of Boulder, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.