Active NPI
Canon City Dental & Implants, PC
- Dentist
- Canon City, CO
National Provider Identifier
1639039621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- CANON CITY DENTAL & IMPLANTS, PC
- Practice address
- 1201 Royal Gorge Blvd
Canon City, CO 81212-3835 - Phone
- (719) 285-0241
- Fax
- (719) 285-0251
- NPI assigned
- Nov 13, 2025
- Last updated
- Nov 13, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Enjoli Guillory
- Title
- Director of RCM
- Phone
- (719) 464-0753
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | NU | Primary |
Addresses
Primary practice location
1201 Royal Gorge Blvd
Canon City, CO 81212-3835
Mailing address
2041 Pepper LN
Pueblo, CO 81005-3276
Phone (719) 285-0241
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762992000000",
"number": "1639039621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 PEPPER LN",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810053276",
"telephone_number": "719-285-0241",
"fax_number": "719-285-0251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 ROYAL GORGE BLVD",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812123835",
"telephone_number": "719-285-0241",
"fax_number": "719-285-0251"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CANON CITY DENTAL & IMPLANTS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2025-11-13",
"last_updated": "2025-11-13",
"certification_date": "2025-11-13",
"status": "A",
"authorized_official_last_name": "GUILLORY",
"authorized_official_first_name": "ENJOLI",
"authorized_official_title_or_position": "DIRECTOR OF RCM",
"authorized_official_telephone_number": "719-464-0753"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Canon City, CO
- Canon Anesthesia Services, Inc
- Canon Chiropractic LLC
- Canon City Co Multi Specialty ASC LLC (Arkansas Valley Surgery Center)
- Canon City Counseling & Psychotherapy Services
- Canon City Counseling, Inc
- Canon City Nursing and Rehab Center, LLC
- Canon City OBGYN PC
- Canon City Physiotherapy Inc
- Canon Kids Dental & Braces, PC
- Canon Professional Wellness Clinic LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.