NPIMap

Organization Active NPI

Boulder Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Boulder, CO
National Provider Identifier
1154713402
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
6921 Issued in CO
Legal business name
BOULDER ORTHODONTICS
Practice address
2710 Pearl St
Boulder, CO 80302-3814
Phone
(303) 449-3250
Fax
(303) 449-1693
NPI assigned
Feb 24, 2015
Last updated
Mar 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
Dr. Jamon Jensen, DDSNPI 1548492887
Title
Owner
Phone
(303) 449-3250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 6921 CO Primary

Addresses

Primary practice location

2710 Pearl St
Boulder, CO 80302-3814

Mailing address

2710 Pearl St
Boulder, CO 80302-3814
Phone (303) 449-3250

National Provider Directory

National Provider Directory

Locations

2710 Pearl St
Boulder, CO 80302
Phone (303) 449-3250

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1154713402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 PEARL ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023814",
            "telephone_number": "303-449-3250",
            "fax_number": "303-449-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 PEARL ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023814",
            "telephone_number": "303-449-3250",
            "fax_number": "303-449-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "JAMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-449-3250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "6921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.