NPIMap

Organization Active NPI

Condar,Inc

  • Dental Clinic/Center
  • Brush, CO
National Provider Identifier
1013105436
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
104803 Issued in CO
Legal business name
CONDAR,INC
Practice address
412 Edison St
Brush, CO 80723-2130
Phone
(970) 842-0220
Fax
(970) 842-0224
NPI assigned
Oct 10, 2007
Last updated
Oct 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
Thomas Jorgensen, DDSNPI 1831312958
Title
Dentist
Phone
(303) 489-1831

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 104803 CO Primary

Addresses

Primary practice location

412 Edison St
Brush, CO 80723-2130

Mailing address

PO Box 563
Brush, CO 80723-0563
Phone (970) 842-0220

Other identifiers 1

IdentifierTypeStateIssuer
96774738MedicaidCO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1013105436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 563",
            "city": "BRUSH",
            "state": "CO",
            "postal_code": "807230563",
            "telephone_number": "970-842-0220",
            "fax_number": "970-842-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 EDISON ST",
            "city": "BRUSH",
            "state": "CO",
            "postal_code": "807232130",
            "telephone_number": "970-842-0220",
            "fax_number": "970-842-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONDAR,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "JORGENSEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "303-489-1831",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "104803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96774738",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brush, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.