NPIMap

Organization Active NPI

Colorado Springs Dental Services PC

Doing business as Blake Street Dental PC

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1093932881
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COLORADO SPRINGS DENTAL SERVICES PC
Doing business as
Blake Street Dental PC
Practice address
685 Citadel Dr E
Suite 300
Colorado Springs, CO 80909-5314
Phone
(719) 591-2004
Fax
(719) 623-0305
NPI assigned
Apr 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Arnold Bradley Cullum, DDSNPI 1265659049
Title
Ceo President
Phone
(719) 591-2004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

685 Citadel Dr E
Suite 300
Colorado Springs, CO 80909-5314

Mailing address

1732 Blake St
Denver, CO 80202-1226
Phone (303) 814-2200

Other names 1

  • Blake Street Dental PC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colorado Springs Dental Services PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1732 Blake St
Denver, CO 80202

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093932881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 BLAKE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021226",
            "telephone_number": "303-814-2200",
            "fax_number": "719-623-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 CITADEL DR E",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095314",
            "telephone_number": "719-591-2004",
            "fax_number": "719-623-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPRINGS DENTAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CULLUM",
        "authorized_official_first_name": "ARNOLD",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "719-591-2004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blake Street Dental PC",
            "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 Aug 22, 2020; 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.