Governor'S Park Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105046 Issued in CO

Legal business name

GOVERNOR'S PARK DENTAL GROUP

Practice address

700 E 9TH Ave
Suite 102
Denver, CO 80203-3360

Phone

(303) 832-7789

Fax

(303) 832-0427

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Terry L Brewick, D.D.S.NPI 1225227044

Title

Owner

Phone

(303) 832-7789

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terry L. Brewick, D.D.S

  • Dentist
  • Denver, CO
  • NPI 1225227044
  NPD (past) Authorized official

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1245256643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E 9TH AVE",
            "address_2": "SUITE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033360",
            "telephone_number": "303-832-7789",
            "fax_number": "303-832-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E 9TH AVE",
            "address_2": "SUITE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033360",
            "telephone_number": "303-832-7789",
            "fax_number": "303-832-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOVERNOR'S PARK DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "BREWICK",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-832-7789",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DENTAL LISC #",
            "identifier": "105046",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Goulet, LCSW
• Brian A Gout, CAC II
• Robin Galbraith Govanlu, MS, LAC, LPC
• Alexander John Governale, PT, DPT
• Morgan Governale
• Christine Elaine Gowdy, LCSW
• Emma Joy Gowen, FNP
• Kimberly Elmore Gowin, APRN
• Jessica Gowing, MD
• Sourabh Goyal, DO

• General Practice Dentistry in Denver, CO
• Providers in Denver, 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 Oct 17, 2007; 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.