Broadmoor Valley Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BROADMOOR VALLEY DENTAL PLLC

Practice address

2965 Broadmoor Valley Rd
Colorado Springs, CO 80906

Phone

(719) 632-7636

Fax

(719) 632-5134

NPI assigned

May 5, 2023

Last updated

May 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Spencer Carter, D.M.D.NPI 1891161402

Title

Owner/Operator

Phone

(208) 709-1612

Specialties & licenses 1

Addresses

Locations

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.

• Spencer Carter, DMD

  • Dentist
  • Colorado Springs, CO
  • NPI 1891161402
  Authorized official Same address or phone

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1144919044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 BROADMOOR VALLEY RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80906",
            "telephone_number": "719-632-7636",
            "fax_number": "719-632-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 BROADMOOR VALLEY RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80906",
            "telephone_number": "719-632-7636",
            "fax_number": "719-632-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADMOOR VALLEY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "208-709-1612",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broadmoor Hearing Clinic LLC
• Broadmoor Lake Dental
• Broadmoor PDC PLLC
• Broadmoor Psychological Services LLC
• Broadmoor Valley Dental Care, PC
• Broadmoor Valley Dental Services, P.C.
• Broadmoor Valley Wellness Center, Inc.
• Brennan Broadway, AGACNP
• Malik Broady
• Ashley Brock

• General Practice Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, 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 May 5, 2023; 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.