Individual provider Active NPI

Antonio Silva Oseguera, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lakewood, CO
National Provider Identifier
1104140201
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
9911 Issued in CO
Practice address
1200 S Wadsworth Blvd
Suite 101
Lakewood, CO 80232-5473
Phone
(303) 934-4285
Fax
(720) 458-3916
NPI assigned
Mar 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 9911 CO Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 24115 TX
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 6085 LA

Addresses

Primary practice location

1200 S Wadsworth Blvd
Suite 101
Lakewood, CO 80232-5473

Mailing address

5601 E Caley Ave
Centennial, CO 80111-4202
Phone (303) 934-4285

Other identifiers 1

IdentifierTypeStateIssuer
41920783MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9911COMDOrthodontics and Dentofacial Orthopedic Dentist
24115TXMDPharmacist
6085LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Antonio Silva DDS PA Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1104140201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 E CALEY AVE",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801114202",
            "telephone_number": "303-934-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S WADSWORTH BLVD",
            "address_2": "SUITE 101",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802325473",
            "telephone_number": "303-934-4285",
            "fax_number": "720-458-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA OSEGUERA",
        "first_name": "ANTONIO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-17",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "9911",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "24115",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "LA",
            "license": "6085",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41920783",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.