Organization Active NPI

Austinbluffs Dental Prof. LLC

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1427360254
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9850 Issued in CO
Legal business name
AUSTINBLUFFS DENTAL PROF. LLC
Practice address
3952 North Academy
Colorado Springs, CO 80917
Phone
(719) 591-1811
Fax
(719) 591-2032
NPI assigned
Jul 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Mrs. Jenniffer Renee Martinez, DDS
Title
Office Manager
Phone
(719) 591-1811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 9850 CO Primary

Addresses

Primary practice location

3952 North Academy
Colorado Springs, CO 80917

Mailing address

3952 N Academy Blvd Ste a
Colorado Springs, CO 80917-5910
Phone (719) 591-1811

National Provider Directory

National Provider Directory

Locations

3952 N Academy Blvd
Colorado Springs, CO 80917
Phone (719) 591-1811

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1427360254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3952 N ACADEMY BLVD STE A",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175910",
            "telephone_number": "719-591-1811",
            "fax_number": "719-591-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3952 NORTH ACADEMY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80917",
            "telephone_number": "719-591-1811",
            "fax_number": "719-591-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTINBLUFFS DENTAL PROF. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JENNIFFER",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-591-1811",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 9, 2010; 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.