NPIMap

Organization Active NPI

Licensed Dental Hygiene Care

  • Voluntary or Charitable Agency
  • Colorado Springs, CO
National Provider Identifier
1407180540
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
20071454175 Issued in CO
Legal business name
LICENSED DENTAL HYGIENE CARE
Practice address
1436 N. Hancock Ave
Colorado Springs, CO 80903
Phone
(719) 338-2195
Fax
(719) 207-8110
NPI assigned
Sep 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Mrs. P. Michelle Vacha, R.D.H.
Title
Executive Director
Phone
(719) 310-3315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X 20071454175 CO Primary

Addresses

Primary practice location

1436 N. Hancock Ave
Colorado Springs, CO 80903

Mailing address

1436 N. Hancock Ave
Colorado Springs, CO 80903
Phone (719) 338-2195

Other names 1

  • Community Dental health, Senior Mobile Dental, Grand Ave Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Dental Health Senior Mobile Dental Grand Ave2 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

1436 N Hancock Ave
Colorado Springs, CO 80903
Phone (719) 471-4884

3650 Rebecca Ln
Colorado Springs, CO 80917
Phone (719) 522-0422

Practitioners & affiliated clinicians

Practitioners 3

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": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1407180540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 N. HANCOCK AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80903",
            "telephone_number": "719-338-2195",
            "fax_number": "719-207-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 N. HANCOCK AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80903",
            "telephone_number": "719-338-2195",
            "fax_number": "719-207-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICENSED DENTAL HYGIENE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "VACHA",
        "authorized_official_first_name": "P.",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-310-3315",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.D.H."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "CO",
            "license": "20071454175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Dental health, Senior Mobile Dental, Grand Ave",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.