Active NPI
Bryce Retzloff
- General Practice Dentistry
- Parker, CO
National Provider Identifier
1245969856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN.00205161
- Practice address
- 19700 E Parker Square Dr
Parker, CO 80134-7301 - Phone
- (720) 605-1696
- NPI assigned
- Jun 8, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN.00205161 | CO | Primary |
Addresses
Primary practice location
19700 E Parker Square Dr
Parker, CO 80134-7301
Mailing address
375 S Jackston St. Apt. 413
Denver, CO 80209
Phone (715) 514-8480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205161 | CO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brighton Modern Dentistry and Orthodontics, LLP | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Brighton, CO
- NPI 1316223662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719964800000",
"number": "1245969856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 S JACKSTON ST. APT. 413",
"city": "DENVER",
"state": "CO",
"postal_code": "80209",
"telephone_number": "715-514-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19700 E PARKER SQUARE DR",
"city": "PARKER",
"state": "CO",
"postal_code": "801347301",
"telephone_number": "720-605-1696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RETZLOFF",
"first_name": "BRYCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-08",
"last_updated": "2024-07-03",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "DEN.00205161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parker, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.