NPIMap

Organization Active NPI

San Juan Smiles Family Dentistry

  • Dentist
  • Durango, CO
National Provider Identifier
1194135921
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8056 Issued in CO
Legal business name
SAN JUAN SMILES FAMILY DENTISTRY
Practice address
2323 W 2ND Ave Ste a
Durango, CO 81301-4646
Phone
(970) 375-7671
Fax
(970) 375-1239
NPI assigned
May 1, 2014
Last updated
May 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Authorized official

Name
Dr. William Lacey, DMDNPI 1265463673
Title
Owner
Phone
(970) 375-7671

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
Dentist 122300000X 8056 CO Primary

Addresses

Primary practice location

2323 W 2ND Ave Ste a
Durango, CO 81301-4646

Mailing address

2323 W 2ND Ave Ste a
Durango, CO 81301-4646
Phone (970) 375-7671

National Provider Directory

National Provider Directory

Locations

2323 W 2nd Ave
Ste A
Durango, CO 81301
Phone (970) 375-7671

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": "1398902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398902400000",
    "number": "1194135921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W 2ND AVE STE A",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014646",
            "telephone_number": "970-375-7671",
            "fax_number": "970-375-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 W 2ND AVE STE A",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014646",
            "telephone_number": "970-375-7671",
            "fax_number": "970-375-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN SMILES FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-01",
        "last_updated": "2014-05-01",
        "status": "A",
        "authorized_official_last_name": "LACEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-375-7671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "8056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; 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.