Michael J. Purcell, DDS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

C07055 Issued in CO

Legal business name

MICHAEL J. PURCELL, DDS

Practice address

1640 Fortino Blvd
Pueblo, CO 81008-1856

Phone

(719) 543-7123

Fax

(719) 253-7761

NPI assigned

Jan 28, 2008

Organization subpart

No

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

Authorized official

Name

Michael J. Purcell, DDS

Title

Owner/Dentist

Phone

(719) 369-8484

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1174700629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081856",
            "telephone_number": "719-543-7123",
            "fax_number": "719-253-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081856",
            "telephone_number": "719-543-7123",
            "fax_number": "719-253-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. PURCELL, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "PURCELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "719-369-8484",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "C07055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02070555",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "789815",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mga Home Healthcare Pueblo, LLC
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• Mi Casa Transitional Services Inc
• Maria Miceli
• Michael a. Ramos, MD., PC
• Michael Kofford DMD; PLLC
• Michael Rosen-Pyros
• Michael T. Rendler, PC
• Chad Michalenko, MD
• Levi Thomas Middleton, LPC

• Dental Clinic/Center in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Dental Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.