Icon Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9970 Issued in CO

Legal business name

ICON DENTAL

Practice address

1425 Market St Ste 100
Denver, CO 80202-1708

Phone

(641) 821-0256

NPI assigned

May 19, 2014

Last updated

May 19, 2014By 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

Nazeli Tarjan

Title

Dentist/Owner

Phone

(641) 821-0256

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1467863977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 MARKET ST STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021708",
            "telephone_number": "641-821-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 MARKET ST STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021708",
            "telephone_number": "641-821-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICON DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "TARJAN",
        "authorized_official_first_name": "NAZELI",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "641-821-0256"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Denver, CO
• Providers in Denver, 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 May 19, 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.