NPIMap

Organization Active NPI

Modern Dental Professionals Co, PC

  • General Practice Dentistry
  • Parker, CO
National Provider Identifier
1013288752
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MODERN DENTAL PROFESSIONALS CO, PC
Practice address
11183 S Parker Rd
Unit C
Parker, CO 80134-4904
Phone
(303) 840-2204
NPI assigned
Jan 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Authorized official

Name
Dr. Craig Mellor, DDS
Title
President
Phone
(714) 428-2000

Specialties & licenses 1

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

Addresses

Primary practice location

11183 S Parker Rd
Unit C
Parker, CO 80134-4904

Mailing address

11183 S Parker Rd
Unit C
Parker, CO 80134-4904
Phone (303) 840-2204

Other names 1

  • BRIGHTNOW PARKER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Modern Dental Profesionals Co PC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

11183 S Parker Rd
Unit C
Parker, CO 80134
Phone (303) 805-3655

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1013288752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11183 S PARKER RD",
            "address_2": "UNIT C",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801344904",
            "telephone_number": "303-840-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11183 S PARKER RD",
            "address_2": "UNIT C",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801344904",
            "telephone_number": "303-840-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL PROFESSIONALS CO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "MELLOR",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-428-2000",
        "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": "BRIGHTNOW PARKER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.