NPIMap

Organization Active NPI

Comprehensive Aesthetic Dental Associates LLC

  • General Practice Dentistry
  • Longmont, CO
National Provider Identifier
1386085520
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104163 Issued in CO
Legal business name
COMPREHENSIVE AESTHETIC DENTAL ASSOCIATES LLC
Practice address
1055 17TH Ave
Suite 104
Longmont, CO 80501-2680
Phone
(303) 776-1335
Fax
(303) 776-7516
NPI assigned
Jul 16, 2013
Last updated
Oct 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Authorized official

Name
Dr. Todd Michael Roby, D.D.S.NPI 1457349664
Title
President/Owner
Phone
(303) 641-0954

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104163 CO Primary

Addresses

Primary practice location

1055 17TH Ave
Suite 104
Longmont, CO 80501-2680

Mailing address

1055 17TH Ave
Suite 104
Longmont, CO 80501-2680
Phone (303) 776-1335

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1373932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1386085520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 17TH AVE",
            "address_2": "SUITE 104",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012680",
            "telephone_number": "303-776-1335",
            "fax_number": "303-776-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 17TH AVE",
            "address_2": "SUITE 104",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012680",
            "telephone_number": "303-776-1335",
            "fax_number": "303-776-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE AESTHETIC DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-16",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "ROBY",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "303-641-0954",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "104163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.