Pedo Lakewood LLC

Primary specialty

DentistTaxonomy code 122300000X

License

00202066 Issued in CO

Legal business name

PEDO LAKEWOOD LLC

Practice address

9990 W 26TH Ave
Lakewood, CO 80215-1581

Phone

(303) 202-0880

Fax

(303) 202-0882

NPI assigned

Feb 10, 2015

Organization subpart

No

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

Authorized official

Name

Jeremy Catmull

Title

Manager of Pedo Lakewood LLC

Phone

(801) 885-0635

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1275924425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9990 W 26TH AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802151581",
            "telephone_number": "303-202-0880",
            "fax_number": "303-202-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9990 W 26TH AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802151581",
            "telephone_number": "303-202-0880",
            "fax_number": "303-202-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDO LAKEWOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "CATMULL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "MANAGER OF PEDO LAKEWOOD LLC",
        "authorized_official_telephone_number": "801-885-0635"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darby Jane Pedersen, ND
• Pediatric Dental Group at Kids First
• Pediatric Dental Group of Lakewood
• Pediatrix Primary Care of Colorado, PLLC
• Pediatrix Urgent Care of Colorado, PLLC
• Pedo Two, Prof. LLC
• Shannon Peistrup
• Susan M Pelikan, PA
• Emily Pelletier
• Sydney Peltier

• Dentist in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.