NPIMap

Organization Active NPI

Colorado Dental Providers

  • General Practice Dentistry
  • Centennial, CO
National Provider Identifier
1417032244
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8054 Issued in CO
Legal business name
COLORADO DENTAL PROVIDERS
Practice address
8170 S University Blvd
Suite 240
Centennial, CO 80122-3196
Phone
(303) 770-1106
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John Everett Ballard
Title
Cio
Phone
(972) 755-0800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 8054 CO Primary

Addresses

Primary practice location

8170 S University Blvd
Suite 240
Centennial, CO 80122-3196

Mailing address

4100 McEwen Rd
Suite 110
Dallas, TX 75244-5113
Phone (972) 755-0800

National Provider Directory

National Provider Directory
Tax ID family
Colorado Dental Providers2 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

8170 S University Blvd
Ste 240
Centennial, CO 80122
Phone (303) 770-1106

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": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417032244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 MCEWEN RD",
            "address_2": "SUITE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445113",
            "telephone_number": "972-755-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 S UNIVERSITY BLVD",
            "address_2": "SUITE 240",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801223196",
            "telephone_number": "303-770-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EVERETT",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "972-755-0800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • 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.