Pediatric Dental Associates of Colorado

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

7396 Issued in CO

Legal business name

PEDIATRIC DENTAL ASSOCIATES OF COLORADO

Doing business as

Children's Dentistry

Practice address

3795 S Colorado Blvd
Englewood, CO 80113-4202

Phone

(303) 522-4703

NPI assigned

May 27, 2008

Last updated

May 27, 2008By 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

Dr. Lisa Carlson-Marks, DDS

Title

Owner

Phone

(303) 594-2214

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Children's Dentistry Doing business as

Locations

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.

• Meredith Anne Harris, MD, DDS

  • Dentist
  • Aurora, CO
  • NPI 1346468733
  NPD (past)

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1679731764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 POTOMAC ST",
            "address_2": "#306",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800116703",
            "telephone_number": "303-537-0234",
            "fax_number": "720-858-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3795 S COLORADO BLVD",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801134202",
            "telephone_number": "303-522-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES OF COLORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "CARLSON-MARKS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-594-2214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "7396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04474562",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55931375",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56982771",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71905774",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin Blair Pearson, D.D.S.
• Julie Peck, NP
• Sarah Joy Peck, DPT
• Susan Elizabeth Peck, MD
• Francis Pedder
• Erika Britt Peksens, BSN
• Pramuk Peliyagoda, DPT
• Kaitlyn Laurel Pell, PA-C
• Jennifer Pelo, LPC
• Emma Peltes

• Pediatric Dentistry in Englewood, CO
• Providers in Englewood, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.