38TH Modern Dental Practice, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

38TH MODERN DENTAL PRACTICE, LLC

Doing business as

38th Modern Dental

Practice address

3550 W 38TH Ave.
#5
Denver, CO 80211

Phone

(303) 515-7008

Fax

(888) 790-7062

NPI assigned

Aug 1, 2017

Last updated

Aug 1, 2017By 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

Scott Frederick, DDS

Title

Owner

Phone

(303) 515-7008

Specialties & licenses 4

Addresses

Other names 1

• 38th Modern Dental Doing business as

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501545600000",
    "number": "1609390632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 N CAREFREE CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222402",
            "telephone_number": "719-266-2717",
            "fax_number": "888-790-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 W 38TH AVE.",
            "address_2": "#5",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "303-515-7008",
            "fax_number": "888-790-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "38TH MODERN DENTAL PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-01",
        "last_updated": "2017-08-01",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-515-7008",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "38th Modern Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Denver, CO
• Providers in Denver, 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 Aug 1, 2017; 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.