Organization Active NPI

Colorado Dental Professionals, LLC

  • General Practice Dentistry
  • Firestone, CO
National Provider Identifier
1245905124
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Practice address
6145 Firestone Blvd
Firestone, CO 80504-5879
Phone
(720) 204-4074
NPI assigned
Aug 12, 2021
Organization subpart
Yes
Parent organization
COLORADO DENTAL PROFESSIONALS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6145 Firestone Blvd
Firestone, CO 80504-5879

Mailing address

6145 Firestone Blvd
Firestone, CO 80504-5879
Phone (720) 204-4074

Other names 1

  • Oak Meadows Village Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colorado Dental Professionals LLC44 organizations share this tax ID, including this one
Part of
Colorado Dental Professionals LLC

Other organizations with this tax ID 43

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

View all 43

Locations

6145 Firestone Blvd
Firestone, CO 80504
Phone (720) 204-4074

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1245905124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6145 FIRESTONE BLVD",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805045879",
            "telephone_number": "720-204-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6145 FIRESTONE BLVD",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805045879",
            "telephone_number": "720-204-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Meadows Village Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Firestone, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.