NPIMap

Organization Active NPI

Front Range Dental Center, PLLC

  • General Practice Dentistry
  • Fort Collins, CO
National Provider Identifier
1386053270
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8604 Issued in CO
Legal business name
FRONT RANGE DENTAL CENTER, PLLC
Practice address
2720 Council Tree Ave
Suite 260
Fort Collins, CO 80525-6306
Phone
(970) 673-7321
Fax
(855) 889-6591
NPI assigned
Aug 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Authorized official

Name
Kurt Radtke
Title
Office Manager
Phone
(970) 673-7321

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 8604 CO Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9157 CO
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9442 CO
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 202039 CO

Addresses

Primary practice location

2720 Council Tree Ave
Suite 260
Fort Collins, CO 80525-6306

Mailing address

2720 Council Tree Ave
Suite 260
Fort Collins, CO 80525-6306
Phone (970) 673-7321

National Provider Directory

National Provider Directory

Locations

2720 Council Tree Ave
Ste 260
Fort Collins, CO 80525
Phone (970) 673-7321

Practitioners & affiliated clinicians

Practitioners 2

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": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1386053270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 COUNCIL TREE AVE",
            "address_2": "SUITE 260",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805256306",
            "telephone_number": "970-673-7321",
            "fax_number": "855-889-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 COUNCIL TREE AVE",
            "address_2": "SUITE 260",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805256306",
            "telephone_number": "970-673-7321",
            "fax_number": "855-889-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONT RANGE DENTAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "RADTKE",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-673-7321"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8604",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9157",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9442",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "202039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 5, 2014; 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.