NPIMap

Organization Active NPI

Colorado Dental Orthodontist Practice, PLLC

Doing business as South Springs Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Colorado Springs, CO
National Provider Identifier
1093398216
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC
Doing business as
South Springs Orthodontics
Practice address
6514 S Academy Blvd
Colorado Springs, CO 80906-8614
Phone
(719) 494-0718
NPI assigned
May 5, 2021
Last updated
May 5, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COLORADO DENTAL ORTHODONTIST PRACTICE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Authorized official

Name
Michelle Johnson
Title
Credentialing Specialist
Phone
(509) 315-8338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

6514 S Academy Blvd
Colorado Springs, CO 80906-8614

Mailing address

6514 S Academy Blvd
Colorado Springs, CO 80906-8614

Other names 1

  • South Springs Orthodontics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address southsprings@peakdentalservices.com

National Provider Directory

National Provider Directory
Tax ID family
Colorado Dental Orthodontist Practice PLLC13 organizations share this tax ID, including this one
Part of
Colorado Dental Orthodontist Practice PLLC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1093398216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6514 S ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809068614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6514 S ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809068614",
            "telephone_number": "719-494-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "509-315-8338"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "southsprings@peakdentalservices.com",
            "affiliation": "N",
            "address_1": "6514 S Academy Blvd",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809068614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "South Springs Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.