NPIMap

Organization Active NPI

Mississippi Dental Group P.C.

  • General Practice Dentistry
  • Aurora, CO
National Provider Identifier
1194846667
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6097 Issued in CO
Legal business name
MISSISSIPPI DENTAL GROUP P.C.
Practice address
11175 E Mississippi Ave
Suite 110
Aurora, CO 80012-3137
Phone
(303) 343-9313
Fax
(303) 343-9537
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Laurie Summers
Title
Credentialing
Phone
(303) 285-6098

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6097 CO Primary

Addresses

Primary practice location

11175 E Mississippi Ave
Suite 110
Aurora, CO 80012-3137

Mailing address

11175 E Mississippi Ave
Suite 110
Aurora, CO 80012-3137
Phone (303) 343-9313

Other names 1

  • Mississippi Dental Group P.C. Doing business as

National Provider Directory

National Provider Directory

Locations

11175 E Mississippi Ave
Ste 110
Aurora, CO 80012
Phone (303) 343-9313

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194846667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 E MISSISSIPPI AVE",
            "address_2": "SUITE 110",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123137",
            "telephone_number": "303-343-9313",
            "fax_number": "303-343-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 E MISSISSIPPI AVE",
            "address_2": "SUITE 110",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123137",
            "telephone_number": "303-343-9313",
            "fax_number": "303-343-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI DENTAL GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "303-285-6098"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mississippi Dental Group P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.