Phillip Earl Pontious, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9227 Issued in CO

Practice address

1204 Main St
Canon City
Canon City, CO 81212-3506

Phone

(719) 275-2887

Fax

(719) 275-2761

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154544666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST",
            "address_2": "CANON CITY",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123506",
            "telephone_number": "719-275-2887",
            "fax_number": "719-275-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST",
            "address_2": "CANON CITY",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123506",
            "telephone_number": "719-275-2887",
            "fax_number": "719-275-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTIOUS",
        "first_name": "PHILLIP",
        "middle_name": "EARL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula M. Peterson, LMT, MSOM
• Carol J Pfaffly, PHD
• William Robert Pierce
• Alexandra Catherine Pluta, LCSW
• Poncha Moor Healthcare, Inc
• Poudre Valley Medical Group, LLC
• Poudre Valley Medical Group, LLC
• Poudre Valley Medical Group, LLC
• Sarah Marie Pridemore, PTA
• Pueblo Radiological Group, P.C.

• General Practice Dentistry in Canon City, CO
• Providers in Canon City, 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 8, 2007; 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.