NPIMap

Organization Active NPI

Mountain Smiles, PLLC

  • General Practice Dentistry
  • Longmont, CO
National Provider Identifier
1093428757
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MOUNTAIN SMILES, PLLC
Practice address
541 Main St
Longmont, CO 80501-5536
Phone
(903) 776-3030
NPI assigned
Dec 27, 2022
Organization subpart
Yes
Parent organization
MOUNTAIN SMILES, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Authorized official

Name
Jenny Organista
Title
Director of RCM
Phone
(917) 966-0422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

541 Main St
Longmont, CO 80501-5536

Mailing address

541 Main St
Longmont, CO 80501-5536
Phone (903) 776-3030

Other names 1

  • Pine Ridge Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mountain Smiles PLLC4 organizations share this tax ID, including this one
Part of
Mountain Smiles PLLC

Other organizations with this tax ID 3

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

Locations

541 Main St
Longmont, CO 80501
Phone (303) 776-0312

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": "1672099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1093428757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805015536",
            "telephone_number": "903-776-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805015536",
            "telephone_number": "903-776-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN SMILES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNTAIN SMILES, PLLC",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "ORGANISTA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "917-966-0422"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Ridge Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.