Perfect Teeth - West 120TH Avenue P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6097 Issued in CO

Legal business name

PERFECT TEETH - WEST 120TH AVENUE P.C.

Doing business as

Perfect Teeth - West 120th Avenue P.C.

Practice address

6650 W 120TH Ave
A-6
Broomfield, CO 80020-7614

Phone

(303) 469-1970

Fax

(303) 469-6157

NPI assigned

Apr 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurie Summers

Title

Credentialing

Phone

(303) 285-6098

Specialties & licenses 1

Addresses

Other names 1

• Perfect Teeth - West 120th Avenue P.C. Doing business as

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235250630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 W 120TH AVE",
            "address_2": "A-6",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207614",
            "telephone_number": "303-469-1970",
            "fax_number": "303-469-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 W 120TH AVE",
            "address_2": "A-6",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207614",
            "telephone_number": "303-469-1970",
            "fax_number": "303-469-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT TEETH - WEST 120TH AVENUE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "303-285-6098"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perfect Teeth - West 120th Avenue P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Elizabeth Peebles, DDS
• Andrew James Pelle, DO
• Karen Percival, PT
• Victoria Pereira, NCTMB
• Marisa Perez-Wilson, O.D.
• Stephanie Lynn Perri, LPC
• Susan K. Peters, MS, LPC
• Debra Jean Petersen, NP
• Derek Gene Petersen, D.D.S.
• Catherine Elizabeth Peterson, PA

• 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 Aug 22, 2020; 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.