Individual provider Active NPI

Alexandra Nani Onodera-Paulson, DDS

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1043732753
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
00205733 Issued in CO
Practice address
7935 Constitution Ave Ste 110
Colorado Springs, CO 80951-8903
Phone
(719) 596-9668
NPI assigned
Jul 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 101550 CA
General Practice Dentistry 1223G0001X 00205733 CO Primary

Addresses

Primary practice location

7935 Constitution Ave Ste 110
Colorado Springs, CO 80951-8903

Mailing address

7501 Loch Fyne LN
Colorado Springs, CO 80908-4794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231115001699 CO Order and Referring Only - DentistPractitioner - Dentist 7315394129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101550CAMDGeneral Practice Dentistry
00205733COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1043732753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 LOCH FYNE LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809084794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7935 CONSTITUTION AVE STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809518903",
            "telephone_number": "719-596-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONODERA-PAULSON",
        "first_name": "ALEXANDRA",
        "middle_name": "NANI",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101550",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00205733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.