South Federal Dental GP PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105415 Issued in CO

Legal business name

SOUTH FEDERAL DENTAL GP PC

Practice address

1601 So Federal Blvd
Suite 201
Denver, CO 80219

Phone

(303) 934-0232

Fax

(303) 934-2208

NPI assigned

Dec 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dale L FarmerNPI 1578745105

Title

President

Phone

(303) 934-0232

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Dale Leroy Farmer, D.D.S.

  • Dentist
  • Denver, CO
  • NPI 1578745105
  NPD (past) Authorized official
• Porfirio Ben Sanchez, D.D.S.

  • Dentist
  • Denver, CO
  • NPI 1144322793
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386706430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SO FEDERAL BLVD",
            "address_2": "SUITE 201",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80219",
            "telephone_number": "303-934-0232",
            "fax_number": "303-934-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SO FEDERAL BLVD",
            "address_2": "SUITE 201",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80219",
            "telephone_number": "303-934-0232",
            "fax_number": "303-934-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FEDERAL DENTAL GP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-934-0232"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04001301",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy Lynn Souser
• South Denver Dental Group LLP
• South Denver Nephrology Associates PLLC
• South Denver Neuromonitoring
• South Denver Neurosurgery Assistance, LLC
• South Federal Dental Partners PLLC (Comfort Dental of South Denver)
• South Federal Family Practice
• South Logan Family Practice
• South Logan Family Practice Center
• South Logan Medical Management SVCS LLC

• General Practice Dentistry in Denver, CO
• Providers in Denver, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.