Pagosa Peak Family Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PAGOSA PEAK FAMILY DENTISTRY, PLLC

Practice address

228 Village Dr
Pagosa Springs, CO 81147-8308

Phone

(216) 374-5693

NPI assigned

Jan 28, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Peter Roukema, DMDNPI 1457525263

Title

President

Phone

(216) 374-5693

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter James Roukema, D.M.D.

  • General Practice Dentistry
  • Pagosa Springs, CO
  • NPI 1457525263
  NPD Authorized official

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1184377392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HAREBELL DR",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811477721",
            "telephone_number": "216-374-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 VILLAGE DR",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811478308",
            "telephone_number": "216-374-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGOSA PEAK FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "ROUKEMA",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-374-5693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pagosa Caritas Family Medicine LLC
• Pagosa Chiropractic
• Pagosa Dental PC
• Pagosa Kids Familydental
• Pagosa P&C Inc. (Pagosa Specialty Pharmacy)
• Pagosa Springs Family Dental LLC
• Pagosa Springs Family Medical Center
• Pagosa Springs Family Medicine Center PC
• Pagosa Womens Health and Wellness Inc.
• Deborah Parker, PH.D.

• Dental Clinic/Center in Pagosa Springs, CO
• Providers in Pagosa Springs, 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, 2022; 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.