NPIMap

Organization Active NPI

SJ Dental PC

  • Dentist
  • Centennial, CO
National Provider Identifier
1285905810
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9613 Issued in CO
Legal business name
SJ DENTAL PC
Practice address
6979 S Holly Cir
#225
Centennial, CO 80112-1577
Phone
(303) 779-1305
Fax
(303) 779-1869
NPI assigned
Jan 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Dr. Maria Johnson, DMDNPI 1831174689
Title
Vice President
Phone
(303) 779-1305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 9614 CO
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 9613 CO Primary

Addresses

Primary practice location

6979 S Holly Cir
#225
Centennial, CO 80112-1577

Mailing address

6979 S Holly Cir
#225
Centennial, CO 80112-1577

National Provider Directory

National Provider Directory

Locations

6979 S Holly Cir
Ste 225
Centennial, CO 80112
Phone (303) 779-1305

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1285905810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "#225",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "#225",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121577",
            "telephone_number": "303-779-1305",
            "fax_number": "303-779-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJ DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "303-779-1305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "9614",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "9613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.