NPIMap

Organization Active NPI

Colorado Dental Professionals, LLC

  • Dentist
  • Commerce City, CO
National Provider Identifier
1659265262
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Practice address
10450 Chambers Rd
Commerce City, CO 80022-8618
Phone
(303) 418-2450
Fax
(303) 418-2452
NPI assigned
Jun 6, 2025
Organization subpart
Yes
Parent organization
COLORADO DENTAL PROFESSIONALS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

10450 Chambers Rd
Commerce City, CO 80022-8618

Mailing address

10450 Chambers Rd
Commerce City, CO 80022-8618
Phone (303) 418-2450

Other names 1

  • Second Creek Dental Care 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

10450 Chambers Rd
Commerce City, CO 80022
Phone (303) 418-2450

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1659265262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 CHAMBERS RD",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800228618",
            "telephone_number": "303-418-2450",
            "fax_number": "303-418-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 CHAMBERS RD",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800228618",
            "telephone_number": "303-418-2450",
            "fax_number": "303-418-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENITILING COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Second Creek Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Commerce City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.

Verify at the official NPI Registry.