Fort Collins Kids Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

20161161840 Issued in CO

Legal business name

FORT COLLINS KIDS DENTISTRY

Practice address

1241 Riverside Ave
Fort Collins, CO 80524-3204

Phone

(970) 632-0306

Fax

(970) 797-2207

NPI assigned

May 7, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Anthony Guido, DDS, MBR

Title

Owner/Dentist

Phone

(970) 672-7525

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Fort Collins Kids Dentistry Doing business as

Locations

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

{
    "created_epoch": "1462579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1326494451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 WOOD ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805211954",
            "telephone_number": "970-672-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243204",
            "telephone_number": "970-632-0306",
            "fax_number": "970-797-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT COLLINS KIDS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-07",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "GUIDO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "970-672-7525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MBR"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CO",
            "license": "02786092",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "20161161840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41489268",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13430734",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90382587",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Collins Kids Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Collins Kids Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.