NPIMap

Organization Active NPI

Primary Dental LLC

Doing business as Primary Dental

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1053441956
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PRIMARY DENTAL LLC
Doing business as
Primary Dental
Practice address
5801 W. 44TH Ave
Unit C
Denver, CO 80212
Phone
(303) 433-1239
Fax
(303) 455-5317
NPI assigned
Mar 7, 2007
Last updated
Nov 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Chadwick N Williamson, DDSNPI 1053448563
Title
Sole Owner
Phone
(303) 433-1239

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5801 W. 44TH Ave
Unit C
Denver, CO 80212

Mailing address

5801 W. 44TH Ave.
Unit C
Denver, CO 80212
Phone (303) 433-1239

Other identifiers 1

IdentifierTypeStateIssuer
68728816MedicaidCO

Other names 1

  • Primary Dental Doing business as

National Provider Directory

National Provider Directory

Locations

5801 W 44th Ave
Unit C
Denver, CO 80212
Phone (303) 433-1239

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1053441956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 W. 44TH AVE.",
            "address_2": "UNIT C",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80212",
            "telephone_number": "303-433-1239",
            "fax_number": "303-455-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 W. 44TH AVE",
            "address_2": "UNIT C",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80212",
            "telephone_number": "303-433-1239",
            "fax_number": "303-455-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "CHADWICK",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "303-433-1239",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68728816",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.