NPIMap

Organization Active NPI

Clear Creek Dental

  • Dentist
  • Fort Collins, CO
National Provider Identifier
1093126237
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8851 Issued in CO
Legal business name
CLEAR CREEK DENTAL
Practice address
373 W Drake Rd Ste 2
Fort Collins, CO 80526-2881
Phone
(970) 223-1166
NPI assigned
May 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Authorized official

Name
Alex Knecht
Title
Owner
Phone
(970) 223-1166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 8851 CO Primary

Addresses

Primary practice location

373 W Drake Rd Ste 2
Fort Collins, CO 80526-2881

Mailing address

373 W Drake Rd Ste 2
Fort Collins, CO 80526-2881
Phone (970) 223-1166

National Provider Directory

National Provider Directory

Locations

373 W Drake Rd
Ste 2
Fort Collins, CO 80526
Phone (970) 223-1166

Practitioners & affiliated clinicians

Practitioners 5

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": "1399593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399593600000",
    "number": "1093126237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 W DRAKE RD STE 2",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262881",
            "telephone_number": "970-223-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 W DRAKE RD STE 2",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262881",
            "telephone_number": "970-223-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR CREEK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-09",
        "last_updated": "2014-05-09",
        "status": "A",
        "authorized_official_last_name": "KNECHT",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-223-1166"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "8851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 9, 2014; 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.