Active NPI
Ronald Glenn Zastrow, D.D.S.
- General Practice Dentistry
- Edwards, CO
National Provider Identifier
1083637169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 464
- Practice address
- 275 Main St Unit O-203
Edwards, CO 81632-7812 - Phone
- (970) 766-7676
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 464 | CO | Primary |
Addresses
Primary practice location
275 Main St Unit O-203
Edwards, CO 81632-7812
Mailing address
275 Main St Unit O-203
Edwards, CO 81632-7812
Phone (970) 766-7676
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 464 | CO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ryan G Zastrow, DDS, PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Edwards, CO
- NPI 1073092037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083637169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 MAIN ST UNIT O-203",
"city": "EDWARDS",
"state": "CO",
"postal_code": "816327812",
"telephone_number": "970-766-7676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 MAIN ST UNIT O-203",
"city": "EDWARDS",
"state": "CO",
"postal_code": "816327812",
"telephone_number": "970-766-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZASTROW",
"first_name": "RONALD",
"middle_name": "GLENN",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edwards, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.