Professional Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

7990 Issued in CO

Legal business name

PROFESSIONAL DENTAL GROUP

Doing business as

Professional Dental Group

Practice address

1120 W South Boulder Rd Ste 204
Lafayette, CO 80026-8952

Phone

(720) 638-2169

Fax

(720) 638-2931

NPI assigned

Dec 2, 2013

Last updated

Dec 2, 2013By 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. Daniel G. Hill, D.D.S.

Title

Owner

Phone

(970) 638-2169

Specialties & licenses 1

Addresses

Other names 1

• Professional Dental Group Doing business as

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1548691520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W SOUTH BOULDER RD STE 204",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268952",
            "telephone_number": "720-638-2169",
            "fax_number": "720-638-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W SOUTH BOULDER RD STE 204",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268952",
            "telephone_number": "720-638-2169",
            "fax_number": "720-638-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-638-2169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "7990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.