NPIMap

Organization Active NPI

Colorado Dental Professionals, LLC

Doing business as Dental Care at Ledge Rock

  • Dentist
  • Johnstown, CO
National Provider Identifier
1659101616
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Doing business as
Dental Care at Ledge Rock
Practice address
4585 Ledge Rock Dr
Johnstown, CO 80534-8007
Phone
(970) 660-4001
NPI assigned
Aug 5, 2024
Last updated
Aug 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COLORADO DENTAL PROFESSIONALS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Cemyira McDougal
Title
Credentialing Coordinator
Phone
(217) 764-8609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

4585 Ledge Rock Dr
Johnstown, CO 80534-8007

Mailing address

4585 Ledge Rock Dr
Johnstown, CO 80534-8007
Phone (970) 660-4001

Other names 1

  • Dental Care at Ledge Rock Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colorado Dental Professionals LLC44 organizations share this tax ID, including this one
Part of
Colorado Dental Professionals LLC

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

4585 Ledge Rock Dr
Johnstown, CO 80534
Phone (970) 660-4001

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1659101616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4585 LEDGE ROCK DR",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805348007",
            "telephone_number": "970-660-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 LEDGE ROCK DR",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805348007",
            "telephone_number": "970-660-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING  COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at Ledge Rock",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnstown, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.