Individual provider Active NPI

Craig Alan Combes, D.D.S.

  • General Practice Dentistry
  • Monte Vista, CO
National Provider Identifier
1083715726
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104798 Issued in CO
Practice address
10 Rupert St
Monte Vista, CO 81144-1042
Phone
(719) 852-2589
Fax
(719) 852-2559
NPI assigned
Sep 26, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104798 CO Primary

Addresses

Primary practice location

10 Rupert St
Monte Vista, CO 81144-1042

Mailing address

10 Rupert St
Monte Vista, CO 81144-1042
Phone (719) 852-2589

Other identifiers 1

IdentifierTypeStateIssuer
02047983MedicaidCO

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

LicenseStateTypeSpecialty
104798COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1083715726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 RUPERT ST",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441042",
            "telephone_number": "719-852-2589",
            "fax_number": "719-852-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 RUPERT ST",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441042",
            "telephone_number": "719-852-2589",
            "fax_number": "719-852-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMBES",
        "first_name": "CRAIG",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "104798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02047983",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monte Vista, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.