Professional Dental Care of Northern Colorado II

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PROFESSIONAL DENTAL CARE OF NORTHERN COLORADO II

Practice address

112 Delmar St
Sterling, CO 80751-4138

Phone

(970) 522-5535

NPI assigned

Oct 23, 2020

Organization subpart

Yes

Parent organization

SSUN HEALTH, LLCAs reported in NPPES

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

Authorized official

Name

Cary Lacouture, DDS

Title

Owner

Phone

(303) 521-5701

Specialties & licenses 1

Addresses

Other names 1

• NorthEastern Dental Associates Doing business as

Part of

Ssun Health LLC

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1376142000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10233 S PARKER RD STE 107",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801349314",
            "telephone_number": "303-887-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 DELMAR ST",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807514138",
            "telephone_number": "970-522-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL CARE OF NORTHERN COLORADO II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSUN HEALTH, LLC",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "LACOUTURE",
        "authorized_official_first_name": "CARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-521-5701",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthEastern Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dani June Powell, RDH
• Laura Powell, BA
• Wendi Powell
• Pradera Dental, P.C.
• Principled Service Internal Medicine
• Boriana Vladimirova Pumpalova, DDS
• R G Lorenzo Pharmacy Inc
• Hannah Raffaeli, DOULA
• Tanya N Read, BSN, RN
• Red Mountain Internal Medicine

• Dental Clinic/Center in Sterling, CO
• Providers in Sterling, 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 Oct 23, 2020; 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.