Ncdi Loveland Professional, LLP

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6177 Issued in CO

Legal business name

NCDI LOVELAND PROFESSIONAL, LLP

Practice address

2700 Madison Square Dr
Loveland, CO 80538-3385

Phone

(970) 669-1122

Fax

(970) 669-1984

NPI assigned

Sep 15, 2015

Organization subpart

No

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

Authorized official

Name

Blanca Richardson

Title

Office Manager

Phone

(970) 669-1122

Specialties & licenses 1

Addresses

Other names 2

• Awesome Smilers Doing business as
• ToothZone Doing business as

Locations

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1144699604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 E 29TH ST STE 274",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382733",
            "telephone_number": "970-669-1122",
            "fax_number": "970-669-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MADISON SQUARE DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805383385",
            "telephone_number": "970-669-1122",
            "fax_number": "970-669-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NCDI LOVELAND PROFESSIONAL, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BLANCA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-669-1122"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "6177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Awesome Smilers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ToothZone",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Loveland, CO
• Providers in Loveland, CO by specialty
• Pediatric Dentistry in Colorado

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