NPIMap

Organization Active NPI

Terry Dental LLC

Doing business as Elizabeth Family Dental

  • General Practice Dentistry
  • Elizabeth, CO
National Provider Identifier
1629456298
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10143 Issued in CO
Legal business name
TERRY DENTAL LLC
Doing business as
Elizabeth Family Dental
Practice address
210 Elizabeth St
St E
Elizabeth, CO 80107-7538
Phone
(303) 646-6336
Fax
(303) 646-5355
NPI assigned
May 14, 2015
Last updated
May 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Authorized official

Name
Dr. Ronald Boone Terry, DMDNPI 1437111721
Title
Owner
Phone
(303) 646-6336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10143 CO Primary

Addresses

Primary practice location

210 Elizabeth St
St E
Elizabeth, CO 80107-7538

Mailing address

210 Elizabeth St
St E.
Elizabeth, CO 80107-7538
Phone (303) 646-6336

Other names 1

  • Elizabeth Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

210 S Elizabeth St
Elizabeth, CO 80107
Phone (303) 646-6336

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1629456298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ELIZABETH ST",
            "address_2": "ST E.",
            "city": "ELIZABETH",
            "state": "CO",
            "postal_code": "801077538",
            "telephone_number": "303-646-6336",
            "fax_number": "303-646-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ELIZABETH ST",
            "address_2": "ST E",
            "city": "ELIZABETH",
            "state": "CO",
            "postal_code": "801077538",
            "telephone_number": "303-646-6336",
            "fax_number": "303-646-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "BOONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-646-6336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elizabeth Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabeth, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.