Organization Active NPI

Dolores Tiongco MD PC

  • Clinical Child & Adolescent Psychologist
  • Grand Junction, CO
National Provider Identifier
1528099280
Registry record updated Dec 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
38987 Issued in CO
Legal business name
DOLORES TIONGCO MD PC
Practice address
2345 N 7TH St
Grand Junction, CO 81501-8117
Phone
(970) 256-0066
Fax
(970) 256-7723
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2007

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

Authorized official

Name
Dr. Dolores Tiongco, MDNPI 1821082546
Title
Owner
Phone
(970) 256-0066

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC2200X 38987 CO Primary

Addresses

Primary practice location

2345 N 7TH St
Grand Junction, CO 81501-8117

Mailing address

2345 N 7TH St
Grand Junction, CO 81501-8117
Phone (970) 256-0066

Other identifiers 1

IdentifierTypeStateIssuer
12073822MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060907000220 CO Part B Supplier - Clinic/Group Practice 1759385628 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Junction, CO

National Provider Directory

National Provider Directory

Locations

541 Hoover Dr
Grand Junction, CO 81504
Phone (970) 256-0066

2345 N 7th St
Grand Junction, CO 81501
Phone (970) 241-8782

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": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196553600000",
    "number": "1528099280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018117",
            "telephone_number": "970-256-0066",
            "fax_number": "970-256-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018117",
            "telephone_number": "970-256-0066",
            "fax_number": "970-256-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOLORES TIONGCO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-12-02",
        "status": "A",
        "authorized_official_last_name": "TIONGCO",
        "authorized_official_first_name": "DOLORES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-256-0066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CO",
            "license": "38987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12073822",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.