Organization Active NPI

Jonathan Anderson DDS PC

  • Dentist
  • Fort Collins, CO
National Provider Identifier
1366986598
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JONATHAN ANDERSON DDS PC
Doing business as
Paragon Dental by Jon Anderson DDS
Practice address
4745 Boardwalk Dr Ste D102
Fort Collins, CO 80525-3773
Phone
(970) 552-7874
NPI assigned
Dec 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Jonathan AndersonNPI 1912084039
Title
President
Phone
(970) 552-7874

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4745 Boardwalk Dr Ste D102
Fort Collins, CO 80525-3773

Mailing address

4360 Boardwalk Dr
Ste 100
Fort Collins, CO 80525-5932
Phone (970) 226-2920

Other names 1

  • Paragon Dental by Jon Anderson DDS Doing business as

National Provider Directory

National Provider Directory

Locations

4360 Boardwalk Dr
Ste 100
Fort Collins, CO 80525
Phone (970) 226-2920

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1366986598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 BOARDWALK DR",
            "address_2": "STE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255932",
            "telephone_number": "970-226-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 BOARDWALK DR STE D102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253773",
            "telephone_number": "970-552-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN ANDERSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-552-7874"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paragon Dental by Jon Anderson DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.