NPIMap

Organization Active NPI

Jana a. Ikeda, DDS, PC

  • Dentist
  • Boulder, CO
National Provider Identifier
1568854271
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7636 Issued in CO
Legal business name
JANA A. IKEDA, DDS, PC
Practice address
805 S Broadway St Ste 210
Boulder, CO 80305-5972
Phone
(303) 499-0558
NPI assigned
Mar 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Authorized official

Name
Jana IkedaNPI 1144254335
Title
President/Dentist
Phone
(303) 499-0558

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7636 CO Primary

Addresses

Primary practice location

805 S Broadway St Ste 210
Boulder, CO 80305-5972

Mailing address

805 S Broadway St Ste 210
Boulder, CO 80305-5972
Phone (303) 499-0558

National Provider Directory

National Provider Directory

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": "1425427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1568854271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S BROADWAY ST STE 210",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055972",
            "telephone_number": "303-499-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S BROADWAY ST STE 210",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055972",
            "telephone_number": "303-499-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANA A. IKEDA, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-04",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "IKEDA",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "303-499-0558"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "7636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.