NPIMap

Organization Active NPI

Fort Collins Modern Dentistry, LLP

  • General Practice Dentistry
  • Fort Collins, CO
National Provider Identifier
1013224062
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FORT COLLINS MODERN DENTISTRY, LLP
Practice address
2203 South College Avenue
Suite 100
Fort Collins, CO 80525
Phone
(970) 482-4455
Fax
(970) 482-1804
NPI assigned
Sep 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Authorized official

Name
Dr. Charles F Rodgers, DDS
Title
Owner
Phone
(970) 482-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2203 South College Avenue
Suite 100
Fort Collins, CO 80525

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 368-2077

Other names 1

  • Fort Collins Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2203 S College Ave
Ste 100
Fort Collins, CO 80525
Phone (970) 482-4455

Practitioners & affiliated clinicians

Practitioners 8

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": "1284076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1013224062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 SOUTH COLLEGE AVENUE",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80525",
            "telephone_number": "970-482-4455",
            "fax_number": "970-482-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT COLLINS MODERN DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-482-4455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Collins Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.