Colorado Gum Care

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

COLORADO GUM CARE

Practice address

899 Hwy 287
Suite 100
Broomfield, CO 80020-7005

Phone

(303) 469-6375

NPI assigned

May 17, 2013

Organization subpart

No

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

Authorized official

Name

Mark A Wheeler, D.M.D.NPI 1649258666

Title

Owner/Dentist

Phone

(303) 457-9617

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Allen Wheeler, D.M.D.

  • Periodontics
  • Broomfield, CO
  • NPI 1649258666
  NPD (past) Authorized official
• Tyler Dale Borg, D.D.S. , M.S.

  • Periodontics
  • Northglenn, CO
  • NPI 1780948794
  NPD (past)
• Matthew A Johanson, D.M.D.

  • Periodontics
  • Northglenn, CO
  • NPI 1194963660
  NPD (past)

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1629414677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11178 HURON ST",
            "address_2": "SUITE 100",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344370",
            "telephone_number": "303-457-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 HWY 287",
            "address_2": "SUITE 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207005",
            "telephone_number": "303-469-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO GUM CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-17",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "303-457-9617",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Edward Collins, MD
• Paul W Collop, LPCC
• Colorado Allergy and Asthma Centers, PC
• Colorado Dental Professionals, LLC
• Colorado Eye Center, LLC
• Colorado Healing Collective
• Colorado Healing Collective
• Colorado Internal Medicine Associates, PC
• Colorado Intraoperative Monitoring
• Colorado Medical Supply

• Periodontics in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Periodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.