Palmer Park Dentistry, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

00007989 Issued in CO

Legal business name

PALMER PARK DENTISTRY, LLC

Practice address

3208 N Academy Blvd
Suite 140
Colorado Springs, CO 80917-5161

Phone

(719) 597-3700

Fax

(719) 597-7507

NPI assigned

Apr 23, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sterling Leon Rogers, DDS

Title

Owner

Phone

(719) 597-3700

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1689061079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3208 N ACADEMY BLVD",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175161",
            "telephone_number": "719-597-3700",
            "fax_number": "719-597-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 N ACADEMY BLVD",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175161",
            "telephone_number": "719-597-3700",
            "fax_number": "719-597-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMER PARK DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "STERLING",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-597-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "00007989",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "00201875",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38873362",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97401862",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Pallini, MD
• Ian Pallozzi
• Sara Alicia Palm, AGACNP-BC
• Palma Counseling Services, LLC
• Madison Palma
• Palmer Park Dentistry, PLLC
• Palmer Park Dentistry, PLLC
• Charice Palmer-Flory, M.A., CCC-SLP
• Andrew Palmer
• Anthony Palmer

• Dentist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.