Individual provider Active NPI

Ellen Walter Vyas, DDS

  • General Practice Dentistry
  • Centennial, CO
National Provider Identifier
1205225042
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
202429 Issued in CO
Practice address
20269 E Smoky Hill Rd
Unit H
Centennial, CO 80015-3111
Phone
(303) 617-5730
Fax
(303) 617-5729
NPI assigned
Jan 16, 2015
Last updated
Jan 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 202429 CO Primary

Addresses

Primary practice location

20269 E Smoky Hill Rd
Unit H
Centennial, CO 80015-3111

Mailing address

20269 E Smoky Hill Rd
Unit H
Centennial, CO 80015-3111
Phone (303) 617-5730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151118000584 CO Order and Referring Only - DentistPractitioner - Dentist 1850691155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202429COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Perfect Teeth - Smoky Hill P.C. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1205225042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20269 E SMOKY HILL RD",
            "address_2": "UNIT H",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800153111",
            "telephone_number": "303-617-5730",
            "fax_number": "303-617-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20269 E SMOKY HILL RD",
            "address_2": "UNIT H",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800153111",
            "telephone_number": "303-617-5730",
            "fax_number": "303-617-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "ELLEN",
        "middle_name": "WALTER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "202429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.