NPIMap

Organization Active NPI

Evergreen Dental Group

  • General Practice Dentistry
  • Evergreen, CO
National Provider Identifier
1215104336
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
HD104930 Issued in CO
Legal business name
EVERGREEN DENTAL GROUP
Practice address
31226 Lewis Ridge Rd
Evergreen, CO 80439-7998
Phone
(303) 674-5566
Fax
(303) 674-8911
NPI assigned
May 8, 2008
Last updated
May 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Authorized official

Name
Dr. Donald SharpNPI 1376540880
Title
Dentist
Phone
(303) 674-5566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X HD104930 CO Primary

Addresses

Primary practice location

31226 Lewis Ridge Rd
Evergreen, CO 80439-7998

Mailing address

31226 Lewis Ridge Rd
Evergreen, CO 80439-7998
Phone (303) 674-5566

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1215104336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31226 LEWIS RIDGE RD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397998",
            "telephone_number": "303-674-5566",
            "fax_number": "303-674-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31226 LEWIS RIDGE RD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397998",
            "telephone_number": "303-674-5566",
            "fax_number": "303-674-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "303-674-5566",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "HD104930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.