Individual provider Active NPI

Mark Pimper, D.D.S.

  • General Practice Dentistry
  • Longmont, CO
National Provider Identifier
1689722720
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
513 Issued in CO
Practice address
2929 17TH Ave
Longmont, CO 80503-1600
Phone
(303) 772-2240
Fax
(303) 651-2518
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 513 CO Primary

Addresses

Primary practice location

2929 17TH Ave
Longmont, CO 80503-1600

Mailing address

2929 17TH Ave
Longmont, CO 80503-1600
Phone (303) 772-2240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421000862 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8123346244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
513COMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689722720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 17TH AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805031600",
            "telephone_number": "303-772-2240",
            "fax_number": "303-651-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 17TH AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805031600",
            "telephone_number": "303-772-2240",
            "fax_number": "303-651-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMPER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.