On-Site Dentist, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9163 Issued in CO

Legal business name

ON-SITE DENTIST, LLC

Practice address

10734 E Berry Ave
Englewood, CO 80111-3972

Phone

(719) 821-2237

NPI assigned

Sep 6, 2017

Organization subpart

No

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

Authorized official

Name

Tyson Pechek, DDS

Title

Director of Dentistry

Phone

(719) 821-2237

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1366960775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3449",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801553449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10734 E BERRY AVE",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801113972",
            "telephone_number": "719-821-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON-SITE DENTIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-06",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "PECHEK",
        "authorized_official_first_name": "TYSON",
        "authorized_official_title_or_position": "DIRECTOR OF DENTISTRY",
        "authorized_official_telephone_number": "719-821-2237",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas A Olmsted, OTR
• Andrew J Olsen, M.D.
• Kiera Olson
• Elaina Marie Olvera
• On Site Endo, LLC
• Elizabeth Ondrako
• One Source Post Acute LLC
• Katherine Ann Oosthuizen, DPT
• Ndudi Okechukwu Oparaeche, MD
• Erin Opat, DPT

• General Practice Dentistry in Englewood, CO
• Providers in Englewood, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.