NPIMap

Organization Active NPI

Summit Smiles PLLC

Doing business as Prestige Dental Center

  • General Practice Dentistry
  • Pueblo, CO
National Provider Identifier
1376256032
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SUMMIT SMILES PLLC
Doing business as
Prestige Dental Center
Practice address
1700 N Salem Ave
Pueblo, CO 81001-2860
Phone
(719) 582-4222
Fax
(719) 414-0027
NPI assigned
Dec 27, 2022
Last updated
Apr 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMIT SMILES PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Jenny Organista
Title
Director of RCM
Phone
(917) 966-0422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1700 N Salem Ave
Pueblo, CO 81001-2860

Mailing address

1700 N Salem Ave
Pueblo, CO 81001-2860
Phone (719) 582-4222

Other names 1

  • Prestige Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Summit Smiles PLLC5 organizations share this tax ID, including this one
Part of
Summit Smiles PLLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1700 N Salem Ave
Pueblo, CO 81001
Phone (719) 582-4222

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1376256032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N SALEM AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810012860",
            "telephone_number": "719-582-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N SALEM AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810012860",
            "telephone_number": "719-582-4222",
            "fax_number": "719-414-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SMILES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT SMILES PLLC",
        "enumeration_date": "2022-12-27",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "ORGANISTA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "917-966-0422"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prestige Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.