NPIMap

Organization Active NPI

Southglenn Modern Dentistry, LLP

  • General Practice Dentistry
  • Centennial, CO
National Provider Identifier
1194957415
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SOUTHGLENN MODERN DENTISTRY, LLP
Practice address
2330 E Arapahoe Rd
Suite 900
Centennial, CO 80122-1508
Phone
(303) 730-3910
Fax
(303) 362-9259
NPI assigned
Aug 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Authorized official

Name
Dr. Charles F Rodgers, DDS
Title
DDS
Phone
(303) 730-3910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2330 E Arapahoe Rd
Suite 900
Centennial, CO 80122-1508

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 368-2077

Other names 1

  • Southglenn Modern Dentisrty Doing business as

National Provider Directory

National Provider Directory

Locations

2330 E Arapahoe Rd
Ste 900
Centennial, CO 80122
Phone (303) 730-3910

Practitioners & affiliated clinicians

Practitioners 7

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": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1194957415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 E ARAPAHOE RD",
            "address_2": "SUITE 900",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801221508",
            "telephone_number": "303-730-3910",
            "fax_number": "303-362-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHGLENN MODERN DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "303-730-3910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southglenn Modern Dentisrty",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.