Front Range Pediatric Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DEN9841 Issued in CO

Legal business name

FRONT RANGE PEDIATRIC DENTISTRY, PLLC

Doing business as

Cool Mountain Kids Pediatric Dentistry

Practice address

6160 Tutt Blvd
Suite 140
Colorado Springs, CO 80923-3500

Phone

(719) 550-1010

Fax

(719) 550-1212

NPI assigned

Apr 23, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Derek Miller, DDSNPI 1013151521

Title

Owner

Phone

(719) 550-1010

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cool Mountain Kids Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Allan Miller, DDS

  • Pediatric Dentistry
  • Colorado Springs, CO
  • NPI 1013151521
  NPD (past) Authorized official

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1285021543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 TUTT BLVD",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809233500",
            "telephone_number": "719-550-1010",
            "fax_number": "719-550-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 TUTT BLVD",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809233500",
            "telephone_number": "719-550-1010",
            "fax_number": "719-550-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONT RANGE PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-550-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "DEN9841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64479871",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cool Mountain Kids Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Front Range Medical Arts, P.C.
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• Front Range Orthopaedics PC
• Front Range Pain Specialists, P.C. (Dr. Stephen M. Ford)
• Front Range Pediatric Therapies LLC
• Front Range Pediatric Therapies LLC
• Front Range Psychology Services, LLC
• Front Range Retina, P.C.
• Front Range Urgent Care, Inc

• Dental Clinic/Center in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Dental Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.