NPIMap

Organization Active NPI

Dentistry360

  • Dental Clinic/Center
  • Denver, CO
National Provider Identifier
1235499294
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
10276 Issued in CO
Legal business name
DENTISTRY360
Practice address
5140 W Dartmouth Ave
Denver, CO 80236-2007
Phone
(720) 596-4760
Fax
(720) 596-4943
NPI assigned
May 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Authorized official

Name
Dr. Semi Condoianis, DDS
Title
Owner
Phone
(214) 693-4022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 10276 CO Primary

Addresses

Primary practice location

5140 W Dartmouth Ave
Denver, CO 80236-2007

Mailing address

5140 W Dartmouth Ave
Denver, CO 80236-2007
Phone (720) 596-4760

Other identifiers 1

IdentifierTypeStateIssuer
58206051MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Dentistry 3602 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5140 W Dartmouth Ave
Denver, CO 80236
Phone (720) 596-4760

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1235499294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 W DARTMOUTH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802362007",
            "telephone_number": "720-596-4760",
            "fax_number": "720-596-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 W DARTMOUTH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802362007",
            "telephone_number": "720-596-4760",
            "fax_number": "720-596-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY360",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "CONDOIANIS",
        "authorized_official_first_name": "SEMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-693-4022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "10276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58206051",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.