Patrick T Prendergast, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105175 Issued in CO

Practice address

6979 S Holly Cir
Suite 185
Centennial, CO 80112-1065

Phone

(303) 771-0225

Fax

(303) 773-3726

NPI assigned

Nov 6, 2006

Last updated

Apr 30, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Dental Health

  • Dentist
  • Centennial, CO
  • NPI 1366829830
  NPD (past) Authorized official
• Advanced Sleep Care Centers of

  • Customized Equipment (DME)
  • Centennial, CO
  • NPI 1821477027
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1417036757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "SUITE 185",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121065",
            "telephone_number": "303-771-0225",
            "fax_number": "303-773-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "SUITE 185",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121065",
            "telephone_number": "303-771-0225",
            "fax_number": "303-773-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "PATRICK",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precision Spine Center LLC
• Precision Therapy, PC
• Preferred Provider Services
• Premier Allergy & Asthma, P.C.
• Premise Health of Colorado Medical PC (Allocares - Centennial)
• Presken Family Care PC
• Kelly Michelle Prestia, MS ED OTR
• Julie Preston Schilling, LCSW
• Cheryl L Prevendar Zuber, PSYD, MAPC, CAGS, MA
• Preventive Health Now, LLC

• General Practice Dentistry in Centennial, CO
• Providers in Centennial, 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 Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.