NPIMap

Organization Active NPI

Colorado Dental Orthodontist Practice, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Colorado Springs, CO
National Provider Identifier
1255914776
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC
Practice address
6110 Barnes Rd
Colorado Springs, CO 80922-2600
Phone
(719) 266-2717
NPI assigned
May 3, 2021
Last updated
May 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Authorized official

Name
Michelle Johnson
Title
Credentialing Specialist
Phone
(509) 315-8338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

6110 Barnes Rd
Colorado Springs, CO 80922-2600

Mailing address

6110 Barnes Rd
Colorado Springs, CO 80922-2600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ins@peakdentalservices.com

National Provider Directory

National Provider Directory
Tax ID family
Colorado Dental Orthodontist Practice PLLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

Subparts reporting this organization as parent 12

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1255914776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600",
            "telephone_number": "719-266-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "509-315-8338"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ins@peakdentalservices.com",
            "affiliation": "N",
            "address_1": "6110 Barnes Rd",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809222600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.