NPIMap

Organization Active NPI

Northern Colorado Periodontics

  • Periodontics
  • Greeley, CO
National Provider Identifier
1437550050
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8350 Issued in CO
Legal business name
NORTHERN COLORADO PERIODONTICS
Practice address
3400 W 16TH St
Suite 5X
Greeley, CO 80634-6862
Phone
(970) 351-6166
Fax
(970) 673-8732
NPI assigned
Sep 15, 2014
Last updated
Sep 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Authorized official

Name
Kelly Olson
Title
Practice Manager
Phone
(970) 351-6166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 8350 CO Primary

Addresses

Primary practice location

3400 W 16TH St
Suite 5X
Greeley, CO 80634-6862

Mailing address

4033 Boardwalk Dr
Suite 100
Fort Collins, CO 80525-5934
Phone (970) 207-4061

National Provider Directory

National Provider Directory

Locations

3400 W 16th St
Ste 5X
Greeley, CO 80634
Phone (970) 351-6166

Practitioners & affiliated clinicians

Practitioners 4

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": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1437550050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 BOARDWALK DR",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255934",
            "telephone_number": "970-207-4061",
            "fax_number": "970-207-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 16TH ST",
            "address_2": "SUITE 5X",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346862",
            "telephone_number": "970-351-6166",
            "fax_number": "970-673-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN COLORADO PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "970-351-6166"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "8350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.