Christopher Daniel Mazzola, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DEN9966 Issued in CO

Practice address

1930 S Nevada Ave
Colorado Springs, CO 80905-3407

Phone

(719) 576-5566

Fax

(719) 576-1100

NPI assigned

Jun 13, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 and National Provider Directory roles.

• Traverse Dental Associates, PLLC

  • General Practice Dentistry
  • Traverse City, MI
  • NPI 1336171800
  Medicare reassignment Authorized official
• Broadmoor Dental, LLC

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1295037646
  NPD (past)
• Colorado Dental Professionals, LLC

  • Dentist
  • Colorado Springs, CO
  • NPI 1093456857
  NPD (past)

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

{
    "created_epoch": "1244851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1427285758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 S. NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809053407",
            "telephone_number": "719-576-5566",
            "fax_number": "719-576-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809053407",
            "telephone_number": "719-576-5566",
            "fax_number": "719-576-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOLA",
        "first_name": "CHRISTOPHER",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-13",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN9966",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN-9966",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianne Rose Maze, RBT
• Katherine S Maziar, MD
• Ashley Maziarski
• Erica Mazzarelli, DPT
• Christina Marie Mazzola, D.D.S.
• Deirdre Raquel McAdams, AGNP
• Labrea McAdams, RBT
• Victoria D McAdams, CNS, APN
• Deborah A. McAdoo, L.M.F.T.
• Megan McAdoo

• Dentist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.