Great Smile Dental Group, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7485 Issued in CO

Legal business name

GREAT SMILE DENTAL GROUP, LLC

Doing business as

Hansen and Amundson Dental Group

Practice address

629 E Star CT
Montrose, CO 81401-6701

Phone

(970) 249-3330

Fax

(970) 249-4171

NPI assigned

Jan 27, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Peter B Amundson, D.M.D.

Title

Member

Phone

(970) 249-3330

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hansen and Amundson Dental Group Doing business as

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1528330297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 E STAR CT",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016701",
            "telephone_number": "970-249-3330",
            "fax_number": "970-249-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 E STAR CT",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016701",
            "telephone_number": "970-249-3330",
            "fax_number": "970-249-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SMILE DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "AMUNDSON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "970-249-3330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04430344",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hansen and Amundson Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Graff & Peterson Dental, LLC
• Christopher B. Graff, D.D.S.
• Julie Graham
• Jean M Granberg
• Grand Junction Vamc
• Darrin Green, MD
• Shelley D Green, MA, LPC, NCC
• Alicia Greene, RDH
• Lindsay Rae Greenfield, DNP
• Laurie Dee Grenoble, MA

• General Practice Dentistry in Montrose, CO
• Providers in Montrose, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.