Retro Dental Broomfield DBD, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RETRO DENTAL BROOMFIELD DBD, LLC

Practice address

5015 W 120TH Ave
Broomfield, CO 80020-5606

Phone

(303) 466-2935

NPI assigned

Jul 11, 2018

Organization subpart

No

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

Authorized official

Name

Jamin Houser, DDS

Title

Chief Dental Officer

Phone

(719) 332-4949

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531267200000",
    "number": "1205312469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 W 120TH AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205606",
            "telephone_number": "303-466-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 W 120TH AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205606",
            "telephone_number": "303-466-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETRO DENTAL BROOMFIELD DBD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A",
        "authorized_official_last_name": "HOUSER",
        "authorized_official_first_name": "JAMIN",
        "authorized_official_title_or_position": "CHIEF DENTAL OFFICER",
        "authorized_official_telephone_number": "719-332-4949",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renaissance Health Care, Inc
• Tomi Rendell, RN
• Catherine Denise Renella, ARNP
• Troy Justin Renfroe
• Mackenzie Julienne Reshew, CPNP-PC, RN
• Retro Dental Group Broomfield
• Roger C Rettig, PT
• Suzette Monique Reuschel, DNP, WHNP, RNC
• Jolynne Reynolds, PH.D., LPC
• Angela Rhoades, RDH

• General Practice Dentistry in Broomfield, CO
• Providers in Broomfield, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.