Open and Affordable Dental Parker West PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

OPEN AND AFFORDABLE DENTAL PARKER WEST PLLC

Practice address

12501 E Lincoln Ave Unit 102
Englewood, CO 80112-4753

Phone

(303) 768-8137

NPI assigned

Jun 3, 2020

Organization subpart

No

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

Authorized official

Name

Igor Traktinskiy

Title

Owner

Phone

(303) 768-8137

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Open and Affordable Dental Parker West Doing business as

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1336763556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 E LINCOLN AVE UNIT 102",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801124753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 E LINCOLN AVE UNIT 102",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801124753",
            "telephone_number": "303-768-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN AND AFFORDABLE DENTAL PARKER WEST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "TRAKTINSKIY",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-768-8137"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000161964",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open and Affordable Dental Parker West",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Open and Affordable Dental Parker West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elizabeth Joy Ordaz Manriquez, CNM

• Dentist in Englewood, CO
• Providers in Englewood, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.