Advanced Dental Health

Primary specialty

DentistTaxonomy code 122300000X

License

105175 Issued in CO

Legal business name

ADVANCED DENTAL HEALTH

Practice address

6979 S Holly Circle #185
Centennial, CO 80112

Phone

(303) 771-0225

Fax

(303) 773-3726

NPI assigned

May 4, 2015

Last updated

May 4, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patrick T PrendergastNPI 1417036757

Title

Dentist

Phone

(303) 771-0225

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Patrick T Prendergast, DDS

  • General Practice Dentistry
  • Centennial, CO
  • NPI 1417036757
  NPD (past) Authorized official

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1366829830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIRCLE #185",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80112",
            "telephone_number": "303-771-0225",
            "fax_number": "303-773-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIRCLE #185",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80112",
            "telephone_number": "303-771-0225",
            "fax_number": "303-773-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "PRENDERGAST",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "303-771-0225",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "105175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVUAL PROVIDER  NPI",
            "identifier": "1417036757",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.