Root Groove, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10245 Issued in CO

Legal business name

ROOT GROOVE, PLLC

Practice address

1101 Teller County Road 1
Cripple Creek, CO 80813

Phone

(719) 689-3565

NPI assigned

Dec 4, 2014

Organization subpart

No

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

Authorized official

Name

Nicole Leadley

Title

Owner

Phone

(719) 352-6633

Specialties & licenses 1

Addresses

Other names 1

• Gold Rush Dental Doing business as

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1225435381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 296",
            "city": "CRIPPLE CREEK",
            "state": "CO",
            "postal_code": "80813",
            "telephone_number": "719-689-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 TELLER COUNTY ROAD 1",
            "city": "CRIPPLE CREEK",
            "state": "CO",
            "postal_code": "80813",
            "telephone_number": "719-689-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOT GROOVE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "LEADLEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-352-6633"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Rush Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alicia Nicole Petri
• Pickett Psychological Services, LLC
• Poudre Valley Medical Group, LLC
• Premier Rural Family Medical & Dental Care, LLC
• Robert Paul Reid, M.D.
• Jill Elaine Saylor, FNP-BC, NP-C
• Southern Teller County Health Services District
• Southern Teller County Health Services District
• Southwest Teller County Emergency Medical Services
• Southwest Teller County Emergency Medical Services

• General Practice Dentistry in Cripple Creek, CO
• Providers in Cripple Creek, 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 Dec 4, 2014; 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.