Boulder Modern Dentistry, LLP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BOULDER MODERN DENTISTRY, LLP

Practice address

2100 28TH St Ste 4F
Boulder, CO 80301-1106

Phone

(303) 442-4455

Fax

(303) 443-0972

NPI assigned

Jul 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. William J McGlashan, DDS

Title

Contracts Admin

Phone

(303) 442-4455

Specialties & licenses 1

Addresses

Other names 1

• Boulder Modern Dentistry Doing business as

Locations

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280448000000",
    "number": "1104130293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE FL 2",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061008",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 28TH ST STE 4F",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011106",
            "telephone_number": "303-442-4455",
            "fax_number": "303-443-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER MODERN DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-30",
        "last_updated": "2010-07-30",
        "status": "A",
        "authorized_official_last_name": "MCGLASHAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CONTRACTS ADMIN",
        "authorized_official_telephone_number": "303-442-4455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "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": "Boulder Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Boulder, CO
• Providers in Boulder, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; 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.