Active NPI
Dale L Pavek, D.D.S.
- General Practice Dentistry
- Colorado Springs, CO
National Provider Identifier
1023076577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3568-5
- Practice address
- USA Dentac, 1631 Wetzel Blvd
BLDG 815
Colorado Springs, CO 80913 - Phone
- (719) 526-5400
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3568-5 | WI | Primary |
Addresses
Primary practice location
USA Dentac, 1631 Wetzel Blvd
BLDG 815
Colorado Springs, CO 80913
Mailing address
USA Dentac, 1631 Wetzel Blvd
BLDG 815
Fort Carson, CO 80913
Phone (719) 526-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3568-5 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023076577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "USA DENTAC, 1631 WETZEL BLVD",
"address_2": "BLDG 815",
"city": "FORT CARSON",
"state": "CO",
"postal_code": "80913",
"telephone_number": "719-526-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "USA DENTAC, 1631 WETZEL BLVD",
"address_2": "BLDG 815",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80913",
"telephone_number": "719-526-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVEK",
"first_name": "DALE",
"middle_name": "L",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "3568-5",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.