Academy Laser Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105236 Issued in CO

Legal business name

ACADEMY LASER DENTISTRY PC

Practice address

6475 Wall St
Suite 201
Colorado Springs, CO 80918-8337

Phone

(719) 260-9000

Fax

(719) 594-9199

NPI assigned

Nov 16, 2010

Last updated

Dec 29, 2010By 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

David W Winn II, DDS

Title

President/Owner

Phone

(719) 260-9000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1649571001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 WALL ST",
            "address_2": "SUITE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809188337",
            "telephone_number": "719-260-9000",
            "fax_number": "719-594-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 WALL ST",
            "address_2": "SUITE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809188337",
            "telephone_number": "719-260-9000",
            "fax_number": "719-594-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY LASER DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "WINN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "719-260-9000",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Colorado Springs, CO
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; 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.