Active NPI
Michael E Allen, D.M.D.
- Dentist
- Pueblo, CO
National Provider Identifier
1346608197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 00202827
- Practice address
- 1800 Fortino Blvd Unit 2
Pueblo, CO 81008-1891 - Phone
- (719) 545-1400
- NPI assigned
- Feb 8, 2016
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 00202827 | CO | Primary |
Addresses
Primary practice location
1800 Fortino Blvd Unit 2
Pueblo, CO 81008-1891
Mailing address
3277 Breckenridge Dr E
Colorado Springs, CO 80906-4538
Phone (719) 494-9706
Other practice location 1
4776 Eagleridge Cir
Pueblo, CO 81008-2189
Phone (719) 553-1000 ext. 5151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00202827 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1346608197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3277 BRECKENRIDGE DR E",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809064538",
"telephone_number": "719-494-9706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 FORTINO BLVD UNIT 2",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810081891",
"telephone_number": "719-545-1400"
}
],
"practiceLocations": [
{
"address_1": "4776 Eagleridge Cir",
"address_purpose": "LOCATION",
"city": "Pueblo",
"state": "CO",
"postal_code": "810082189",
"country_code": "US",
"telephone_number": "719-553-1000 x5151",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALLEN",
"first_name": "MICHAEL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-08",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "00202827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.