NPIMap

Organization Active NPI

Green Gables Dental LLC

  • Dental Anesthesiology
  • Lakewood, CO
National Provider Identifier
1508376906
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
00202170 Issued in CO
Legal business name
GREEN GABLES DENTAL LLC
Practice address
7586 W Jewell Ave # 2-303
Lakewood, CO 80232-6890
Phone
(720) 442-8256
Fax
(720) 442-8246
NPI assigned
Oct 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Authorized official

Name
Michael RiggsNPI 1174698666
Title
Owner
Phone
(720) 442-8256

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 00202170 CO
Dental AnesthesiologyGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0004X 02786101 CO
Dental AnesthesiologyGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0004X 00202170 CO Primary

Addresses

Primary practice location

7586 W Jewell Ave # 2-303
Lakewood, CO 80232-6890

Mailing address

7586 W Jewell Ave # 2-303
Lakewood, CO 80232-6890
Phone (720) 442-8256

Other identifiers 1

IdentifierTypeStateIssuer
1174698666MedicaidCO

Other names 1

  • Michael Riggs Other name

National Provider Directory

National Provider Directory

Locations

7586 W Jewell Ave
#2303
Lakewood, CO 80232
Phone (720) 442-8256

Practitioners & affiliated clinicians

Practitioners 2

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": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511308800000",
    "number": "1508376906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7586 W JEWELL AVE # 2-303",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802326890",
            "telephone_number": "720-442-8256",
            "fax_number": "720-442-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7586 W JEWELL AVE # 2-303",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802326890",
            "telephone_number": "720-442-8256",
            "fax_number": "720-442-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN GABLES DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-11-22",
        "status": "A",
        "authorized_official_last_name": "RIGGS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-442-8256"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202170",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CO",
            "license": "02786101",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CO",
            "license": "00202170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174698666",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Riggs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.