Strasburg Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8950 Issued in CO

Legal business name

STRASBURG DENTAL GROUP

Practice address

820 1St St
Limon, CO 80828

Phone

(719) 775-0300

Fax

(719) 775-0302

NPI assigned

Aug 4, 2005

Organization subpart

No

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

Authorized official

Name

Tabatha C Northup

Title

Office Manager

Phone

(719) 775-0300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Limon Dental Group Other name

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043211667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "LIMON",
            "state": "CO",
            "postal_code": "808280160",
            "telephone_number": "719-775-0300",
            "fax_number": "719-775-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 1ST ST",
            "city": "LIMON",
            "state": "CO",
            "postal_code": "80828",
            "telephone_number": "719-775-0300",
            "fax_number": "719-775-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRASBURG DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NORTHUP",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-775-0300"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90079329",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Limon Dental Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert Robertson
• Rural Rest Homes LLC (Tender Care Village of Limon)
• Amber Lee Satz, PHARMD
• Smithburg Retail Enterprise, Inc. (Hoffman Drug)
• Ryan Lee Smithburg, RPH
• Kirsten Tacha, RDH
• Lucinda Tacha, LCSW
• Shelby Tagtmeyer, DENTAL HYGIENIST
• Thrive Healthcare LLC (Hoffman Medical Supply)
• Town of Limon (Limon Ambulance Service)

• General Practice Dentistry in Limon, CO
• Providers in Limon, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.