NPIMap

Organization Active NPI

Modern Dental Associates

  • Dentist
  • Edwards, CO
National Provider Identifier
1194013342
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7777 Issued in CO
Legal business name
MODERN DENTAL ASSOCIATES
Practice address
27 Main St
Suite 104E
Edwards, CO 81632-8109
Phone
(970) 926-4321
NPI assigned
Jul 20, 2011
Last updated
Jul 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Authorized official

Name
Paula S BarclayNPI 1073789194
Title
Owner
Phone
(970) 926-4321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7777 CO Primary

Addresses

Primary practice location

27 Main St
Suite 104E
Edwards, CO 81632-8109

Mailing address

27 Main St
Suite 104E
Edwards, CO 81632-8109
Phone (970) 926-4321

National Provider Directory

National Provider Directory

Locations

27 Main St
Unit 104E
Edwards, CO 81632
Phone (970) 926-4321

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": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1194013342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MAIN ST",
            "address_2": "SUITE 104E",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816328109",
            "telephone_number": "970-926-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MAIN ST",
            "address_2": "SUITE 104E",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816328109",
            "telephone_number": "970-926-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "BARCLAY",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-926-4321"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "7777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.