NPIMap

Organization Active NPI

Children'S Dentistry, Boulder

  • Pediatric Dentistry
  • Boulder, CO
National Provider Identifier
1578284550
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CHILDREN'S DENTISTRY, BOULDER
Practice address
3400 Penrose PL Ste 107
Boulder, CO 80301-1809
Phone
(303) 443-8250
NPI assigned
Sep 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Dr. Sean Whalen, DDSNPI 1699749598
Title
Owner/Pediatric Dentist
Phone
(720) 226-6061

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

3400 Penrose PL Ste 107
Boulder, CO 80301-1809

Mailing address

3400 Penrose PL Ste 107
Boulder, CO 80301-1809
Phone (303) 443-8250

Other identifiers 1

IdentifierTypeStateIssuer
8954MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@ddschild.com

National Provider Directory

National Provider Directory

Locations

3400 Penrose Pl
Ste 107
Boulder, CO 80301
Phone (303) 443-8250

Practitioners & affiliated clinicians

Practitioners 4

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": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1578284550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 PENROSE PL STE 107",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011809",
            "telephone_number": "303-443-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 PENROSE PL STE 107",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011809",
            "telephone_number": "303-443-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTISTRY, BOULDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "WHALEN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "720-226-6061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8954",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@ddschild.com",
            "affiliation": "N",
            "address_1": "3400 Penrose Pl Ste 107",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803011809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 7, 2022; 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.