Bear Creek Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7300 Issued in CO

Legal business name

BEAR CREEK DENTAL

Practice address

1430 S 21St St
Suite 200
Colorado Springs, CO 80904-4225

Phone

(719) 633-2828

Fax

(719) 633-7461

NPI assigned

Jun 26, 2015

Last updated

Jun 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jessie Bryan Mastin, D.D.S.NPI 1992871909

Title

Owner

Phone

(719) 633-2828

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessie Bryan Mastin, DDS

  • Dentist
  • Colorado Springs, CO
  • NPI 1992871909
  Authorized official Same address or phone

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1275915142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 S 21ST ST",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809044225",
            "telephone_number": "719-633-2828",
            "fax_number": "719-633-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 S 21ST ST",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809044225",
            "telephone_number": "719-633-2828",
            "fax_number": "719-633-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR CREEK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-26",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "MASTIN",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-633-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Anne Beames, COTA/L
• Brianne Marie Bean, LPN
• Margot Lathan Bean, LCSW
• Matthew G Bean, DO
• Tami L Bean, MSW, LCSW
• Bear Creek Family Medicine, Prof. LLC
• Bear Creek Senior Living
• Crystal Beard-Odom, LMT
• Brittany Beard
• Aimee Marcel Bearden, NP-C

• General Practice Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, 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 Jun 26, 2015; 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.