NPIMap

Organization Active NPI

Marc D. Thomas DDS, PC

Doing business as Canyon Ridge Pediatric Dentistry

  • Pediatric Dentistry
  • Parker, CO
National Provider Identifier
1306183736
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
10771 Issued in CO
Legal business name
MARC D. THOMAS DDS, PC
Doing business as
Canyon Ridge Pediatric Dentistry
Practice address
19551 Hess Rd Unit 110
Parker, CO 80134-3446
Phone
(303) 841-7900
Fax
(303) 841-1650
NPI assigned
Jan 4, 2013
Last updated
Jun 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Dr. Marc David Thomas, D.D.S.NPI 1720240005
Title
Pediatric Dentist
Phone
(303) 841-7900

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 10771 CO Primary

Addresses

Primary practice location

19551 Hess Rd Unit 110
Parker, CO 80134-3446

Mailing address

19551 Hess Rd Unit 110
Parker, CO 80134-3446
Phone (303) 841-7900

Other identifiers 1

IdentifierTypeStateIssuer
46455035MedicaidCO

Other names 1

  • Canyon Ridge Pediatric Dentistry Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@canyonridgepd.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Canyon Ridge Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

19551 Hess Rd
Unit 110
Parker, CO 80134
Phone (303) 841-7900

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1306183736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19551 HESS RD UNIT 110",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801343446",
            "telephone_number": "303-841-7900",
            "fax_number": "303-841-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19551 HESS RD UNIT 110",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801343446",
            "telephone_number": "303-841-7900",
            "fax_number": "303-841-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC D. THOMAS DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "303-841-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "10771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46455035",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@canyonridgepd.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19551 Hess Rd Unit 110",
            "city": "Parker",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801343446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Canyon Ridge Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Canyon Ridge Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parker, CO

Sources for this page

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