NPIMap

Organization Active NPI

Legacy Endodontics

  • Endodontics
  • Golden, CO
National Provider Identifier
1386992113
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
9779 Issued in CO
Legal business name
LEGACY ENDODONTICS
Practice address
400 Indiana St
Suite 370
Golden, CO 80401-5027
Phone
(303) 526-1502
Fax
(303) 526-1502
NPI assigned
Aug 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Authorized official

Name
Wade HirschmanNPI 1598923104
Title
Owner/Dentist
Phone
(303) 526-1502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 9779 CO Primary

Addresses

Primary practice location

400 Indiana St
Suite 370
Golden, CO 80401-5027

Mailing address

400 Indiana St
Suite 370
Golden, CO 80401-5027
Phone (303) 526-1502

National Provider Directory

National Provider Directory
Tax ID family
Legacy Endodontics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

400 Indiana St
Ste 370
Golden, CO 80401
Phone (303) 526-1502

Practitioners & affiliated clinicians

Practitioners 1

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": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1386992113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INDIANA ST",
            "address_2": "SUITE 370",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015027",
            "telephone_number": "303-526-1502",
            "fax_number": "303-526-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INDIANA ST",
            "address_2": "SUITE 370",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015027",
            "telephone_number": "303-526-1502",
            "fax_number": "303-526-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "HIRSCHMAN",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "303-526-1502"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "9779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.