Northern Colorado Dental Specialty and Implant Center PLLC

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

Legal business name

NORTHERN COLORADO DENTAL SPECIALTY AND IMPLANT CENTER PLLC

Practice address

1221 E Elizabeth St Ste 4
Fort Collins, CO 80524-4066

Phone

(970) 825-0000

NPI assigned

Sep 29, 2022

Last updated

Sep 29, 2022By 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

Ron Bergloff

Title

Admin

Phone

(970) 825-0000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1619691078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E ELIZABETH ST STE 4",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244066",
            "telephone_number": "970-825-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E ELIZABETH ST STE 4",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244066",
            "telephone_number": "970-825-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN COLORADO DENTAL SPECIALTY AND IMPLANT CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "BERGLOFF",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "970-825-0000"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Prosthodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.