Pueblo Family Dentistry PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PUEBLO FAMILY DENTISTRY PLLC

Practice address

701 N Grand Avenue
Suite B
Pueblo, CO 81003

Phone

(719) 210-4097

NPI assigned

Mar 23, 2020

Last updated

Mar 23, 2020By 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

Dr. Somi M Lim, DDSNPI 1518213297

Title

Dentist/Owner

Phone

(719) 418-2456

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Somi Michelle Lim, DDS

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1518213297
  NPD (past) Authorized official

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1497382303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 S. ACADEMY BLVD.",
            "address_2": "SUITE# 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80916",
            "telephone_number": "719-418-2456",
            "fax_number": "719-247-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N GRAND AVENUE",
            "address_2": "SUITE B",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81003",
            "telephone_number": "719-210-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "SOMI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "719-418-2456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pueblo Family Medicine, PC
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• Pueblo Hearing AIDS LLC
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• Pueblo Infectious Diseases, PLLC

• Dentist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; 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.