Dental Holdings, P.C., Dba Mountain Shadows Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL HOLDINGS, P.C., DBA MOUNTAIN SHADOWS FAMILY DENTISTRY

Practice address

1045 Garden of the Gods Rd Ste N
Colorado Springs, CO 80907-3436

Phone

(719) 598-3502

Fax

(719) 598-9264

NPI assigned

Mar 13, 2018

Organization subpart

No

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

Authorized official

Name

Clint Rivard, DMD

Title

Dentist

Phone

(719) 598-3502

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520899200000",
    "number": "1013410323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 GARDEN OF THE GODS RD STE N",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073436",
            "telephone_number": "719-598-3502",
            "fax_number": "719-598-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 GARDEN OF THE GODS RD STE N",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073436",
            "telephone_number": "719-598-3502",
            "fax_number": "719-598-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HOLDINGS, P.C., DBA MOUNTAIN SHADOWS FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A",
        "authorized_official_last_name": "RIVARD",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "719-598-3502",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Dental Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.