Organization Active NPI

Orthodontic Experts of Colorado, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Colorado Springs, CO
National Provider Identifier
1497261648
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHODONTIC EXPERTS OF COLORADO, PLLC
Practice address
1685 Briargate Blvd Ste B
Colorado Springs, CO 80920-3417
Phone
(847) 749-4340
NPI assigned
Dec 26, 2017
Organization subpart
Yes
Parent organization
ORTHODONTIC EXPERTS OF COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Monika Bzdal
Title
Manager
Phone
(773) 801-7171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1685 Briargate Blvd Ste B
Colorado Springs, CO 80920-3417

Mailing address

1250 W Northwest Hwy
Mount Prospect, IL 60056-2274

Other identifiers 1

IdentifierTypeStateIssuer
00203373MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Experts of Colorado PLLC2 organizations share this tax ID, including this one
Part of
Orthodontic Experts of Colorado PLLC

Other organizations with this tax ID 1

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

Locations

1685 Briargate Blvd
Ste B
Colorado Springs, CO 80920

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1497261648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W NORTHWEST HWY",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 BRIARGATE BLVD STE B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203417",
            "telephone_number": "847-749-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC EXPERTS OF COLORADO, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHODONTIC EXPERTS OF COLORADO",
        "enumeration_date": "2017-12-26",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "BZDAL",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-801-7171"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00203373",
            "state": "CO"
        }
    ],
    "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 Dec 12, 2019; 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.