Advanced Dental Center, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ADVANCED DENTAL CENTER, PLLC

Doing business as

Advanced Dental Center

Practice address

1557 W 84TH Ave Ste 1
Federal Heights, CO 80260-4780

Phone

(303) 426-4860

Fax

(719) 414-0027

NPI assigned

Mar 1, 2024

Last updated

Aug 30, 2024By 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

Mr. John Lydiatt

Title

Owner

Phone

(719) 300-5933

Specialties & licenses 1

Addresses

Other names 1

• Advanced Dental Center Doing business as

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.

• Jason Ronald Vanwagenen, D.D.S.

  • General Practice Dentistry
  • Federal Heights, CO
  • NPI 1669482097
  NPD
• Kenneth Robert Ence, DDS

  • General Practice Dentistry
  • Federal Heights, CO
  • NPI 1801108394
  NPD (past)

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1417714809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 W 84TH AVE STE 1",
            "city": "FEDERAL HEIGHTS",
            "state": "CO",
            "postal_code": "802604780",
            "telephone_number": "303-426-4860",
            "fax_number": "719-414-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 W 84TH AVE STE 1",
            "city": "FEDERAL HEIGHTS",
            "state": "CO",
            "postal_code": "802604780",
            "telephone_number": "303-426-4860",
            "fax_number": "719-414-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "LYDIATT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-300-5933",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 1918 Winter Street Operating Co LLC (Safeway Pharmacy #1635)
• Arthur Dee Abercrombie, DMD
• Addo Home Health Care,Inc (Addo Home Care)
• Advanced Dental Center
• Lori Ann Aichele, RPH
• Ashlynn Ammerman, MA, BCBA
• Elyssabeth Beers, L.P.C.
• Stacie Benson, LPC
• Josephine Bowen

• General Practice Dentistry in Federal Heights, CO
• Providers in Federal Heights, 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 30, 2024; 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.