NPIMap

Organization Active NPI

Summit Smiles PLLC

Doing business as Advanced Dental Center

  • General Practice Dentistry
  • Federal Heights, CO
National Provider Identifier
1487312039
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SUMMIT SMILES 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
(303) 426-1530
NPI assigned
Dec 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Authorized official

Name
John Lydiatt, DDS
Title
Owner
Phone
(303) 426-4860

Specialties & licenses 1

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

Addresses

Primary practice location

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

Mailing address

1557 W 84TH Ave Ste 1
Federal Heights, CO 80260-4780
Phone (303) 426-4860

Other names 1

  • Advanced Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Summit Smiles PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1557 W 84th Ave
Ste 1
Federal Heights, CO 80260
Phone (303) 426-4860

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1487312039",
    "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": "303-426-1530"
        },
        {
            "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": "303-426-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "LYDIATT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-426-4860",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  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"
        }
    ]
}

Other providers in Federal Heights, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.