NPIMap

Organization Active NPI

Brush Dental Inc

  • Dental Clinic/Center
  • Brush, CO
National Provider Identifier
1649628447
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
904552 Issued in CO
Legal business name
BRUSH DENTAL INC
Practice address
412 Edison St
Brush, CO 80723-2130
Phone
(970) 842-0220
Fax
(970) 842-0224
NPI assigned
Jun 2, 2016
Last updated
Feb 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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

Authorized official

Name
Mrs. Therese Gonzales, RDHNPI 1366543639
Title
Owner
Phone
(970) 842-0220

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X 904552 CO
Dental Clinic/Center 261QD0000X 904552 CO Primary

Addresses

Primary practice location

412 Edison St
Brush, CO 80723-2130

Mailing address

412 Edison St
Brush, CO 80723
Phone (970) 842-0220

Other identifiers 1

IdentifierTypeStateIssuer
01335537MedicaidCO

National Provider Directory

National Provider Directory

Locations

412 Edison St
Brush, CO 80723
Phone (970) 842-0220

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": "1464825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1649628447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 EDISON ST",
            "city": "BRUSH",
            "state": "CO",
            "postal_code": "80723",
            "telephone_number": "970-842-0220",
            "fax_number": "970-842-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 EDISON ST",
            "city": "BRUSH",
            "state": "CO",
            "postal_code": "807232130",
            "telephone_number": "970-842-0220",
            "fax_number": "970-842-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUSH DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-02",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "THERESE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-842-0220",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "904552",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "904552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01335537",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brush, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.