NPIMap

Organization Active NPI

My Local Colorado Dental Practice, LLC

  • General Practice Dentistry
  • Aurora, CO
National Provider Identifier
1336726280
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Practice address
990 S Abilene St
Aurora, CO 80012-3686
Phone
(720) 687-3983
NPI assigned
Mar 26, 2021
Organization subpart
Yes
Parent organization
MY LOCAL COLORADO DENTAL PRACTICE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Authorized official

Name
Michelle Johnson
Title
Credentialing Specialist
Phone
(509) 315-8338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

990 S Abilene St
Aurora, CO 80012-3686

Mailing address

6110 Barnes Rd
Colorado Springs, CO 80922-2600

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Aurora

National Provider Directory

National Provider Directory
Tax ID family
My Local Colorado Dental Practice LLC40 organizations share this tax ID, including this one
Part of
My Local Colorado Dental Practice LLC

Other organizations with this tax ID 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1336726280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 S ABILENE ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123686",
            "telephone_number": "720-687-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY LOCAL COLORADO DENTAL PRACTICE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY LOCAL COLORADO DENTAL PRACTICE, LLC",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "509-315-8338"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Aurora",
            "affiliation": "N",
            "address_1": "990 S Abilene St",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800123686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.