Rock Canyon Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

202339 Issued in CO

Legal business name

ROCK CANYON FAMILY DENTAL

Practice address

332 S Orchard Springs Dr Ste 110
Pueblo West, CO 81007-6154

Phone

(719) 924-8858

NPI assigned

Nov 15, 2017

Organization subpart

No

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

Authorized official

Name

Valerie Hall

Title

Business Manager

Phone

(623) 910-5569

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510704000000",
    "number": "1376056192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4542 VALLEYBROOK DR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801306965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 S ORCHARD SPRINGS DR STE 110",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810076154",
            "telephone_number": "719-924-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK CANYON FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "623-910-5569"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "202339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Pueblo West, CO
• Providers in Pueblo West, CO by specialty
• Dental Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.