Mainstreet Dental Center, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

105608 Issued in CO

Legal business name

MAINSTREET DENTAL CENTER, LLC

Practice address

19751 E Mainstreet
R08
Parker, CO 80138-7378

Phone

(303) 955-8490

Fax

(303) 997-9359

NPI assigned

Feb 16, 2007

Last updated

Apr 22, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paula Kay Coffee, DDS

Title

Owner

Phone

(720) 480-4580

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1043354897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19751 E MAINSTREET",
            "address_2": "R08",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801387378",
            "telephone_number": "303-955-8490",
            "fax_number": "303-997-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19751 E MAINSTREET",
            "address_2": "R08",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801387378",
            "telephone_number": "303-955-8490",
            "fax_number": "303-997-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINSTREET DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "COFFEE",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-480-4580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "105608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Macleod, PA-C
• Josie Sarah Macleod, MA
• Maureen Macleod
• Suhitha Madhavaram, M.D.
• Henry Madsen, PT, DPT
• Mainstreet Pediatrics
• Nina Maliszewski
• Daniel Paul Mallett, DPM
• Michael L Malmgren, PA, DC
• Janice Malone

• Dentist in Parker, CO
• Providers in Parker, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.