NPIMap

Organization Active NPI

Simply Kids Dental

  • Pediatric Dentistry
  • Colorado Springs, CO
National Provider Identifier
1619108073
Registry record updated Aug 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9884 Issued in CO
Legal business name
SIMPLY KIDS DENTAL
Practice address
1910 Vindicator Dr
Suite 103
Colorado Springs, CO 80919-3623
Phone
(719) 598-5437
NPI assigned
Aug 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2009

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

Authorized official

Name
Sean VostatekNPI 1114108321
Title
Managing Partner
Phone
(719) 598-5437

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 9884 CO Primary

Addresses

Primary practice location

1910 Vindicator Dr
Suite 103
Colorado Springs, CO 80919-3623

Mailing address

1910 Vindicator Dr
Suite 103
Colorado Springs, CO 80919-3623

National Provider Directory

National Provider Directory

Locations

1910 Vindicator Dr
Ste 103
Colorado Springs, CO 80919
Phone (719) 268-9030

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": "1249344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249344000000",
    "number": "1619108073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 VINDICATOR DR",
            "address_2": "SUITE 103",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 VINDICATOR DR",
            "address_2": "SUITE 103",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193623",
            "telephone_number": "719-598-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY KIDS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-04",
        "last_updated": "2009-08-04",
        "status": "A",
        "authorized_official_last_name": "VOSTATEK",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "719-598-5437"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "9884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.