Neon Kids Dental of Cortez

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

NEON KIDS DENTAL OF CORTEZ

Practice address

101 S Maple St Ste 1
Cortez, CO 81321-3563

Phone

(505) 592-0482

NPI assigned

Apr 29, 2022

Organization subpart

No

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

Authorized official

Name

Amanda Salazar

Title

Billing

Phone

(505) 592-0482

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1265177679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 N BUTLER AVE STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010816",
            "telephone_number": "505-592-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAPLE ST STE 1",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213563",
            "telephone_number": "505-592-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEON KIDS DENTAL OF CORTEZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "505-592-0482"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Cortez, CO
• Providers in Cortez, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.