NPIMap

Organization Active NPI

Travis Willey, DDS PC

Doing business as Family & Cosmetic Dentistry of the Rockies

  • Dentist
  • Fort Collins, CO
National Provider Identifier
1043717382
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TRAVIS WILLEY, DDS PC
Doing business as
Family & Cosmetic Dentistry of the Rockies
Practice address
4745 Boardwalk Dr Ste D102
Fort Collins, CO 80525-3773
Phone
(970) 223-6101
Fax
(970) 530-1593
NPI assigned
Apr 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Authorized official

Name
Teresa Venekamp
Title
Office Manager
Phone
(970) 223-6101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X

Addresses

Primary practice location

4745 Boardwalk Dr Ste D102
Fort Collins, CO 80525-3773

Mailing address

4745 Boardwalk Dr Ste D102
Fort Collins, CO 80525-3773
Phone (970) 223-6101

Other names 1

  • Family & Cosmetic Dentistry of the Rockies Doing business as

National Provider Directory

National Provider Directory

Locations

4745 Boardwalk Dr
Ste D102
Fort Collins, CO 80525
Phone (970) 223-6101

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1043717382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 BOARDWALK DR STE D102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253773",
            "telephone_number": "970-223-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 BOARDWALK DR STE D102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253773",
            "telephone_number": "970-223-6101",
            "fax_number": "970-530-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS WILLEY, DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "VENEKAMP",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-223-6101"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family & Cosmetic Dentistry of the Rockies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.