NPIMap

Organization Active NPI

Regents of the University of Colorado

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Aurora, CO
National Provider Identifier
1700257573
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
DR.0055063 Issued in CO
Legal business name
REGENTS OF THE UNIVERSITY OF COLORADO
Practice address
13065 E 17TH Ave
Mail Stop F742
Aurora, CO 80045-2532
Phone
(303) 724-5509
NPI assigned
Oct 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Mr. Brian Davis, MBA,MSHA,CMA
Title
Associate Dean of Finance Administr
Phone
(303) 724-7132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X DR.0055063 CO Primary

Addresses

Primary practice location

13065 E 17TH Ave
Mail Stop F742
Aurora, CO 80045-2532

Mailing address

13065 E 17TH Ave
Aurora, CO 80045-2532

Other identifiers 1

IdentifierTypeStateIssuer
09034528MedicaidCO

Other names 1

  • School of Dental Medicine, Faculty Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Biochemical Genetics la55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

13065 E 17th Ave
Stop F742
Aurora, CO 80045
Phone (303) 724-5505

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1700257573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13065 E 17TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13065 E 17TH AVE",
            "address_2": "MAIL STOP F742",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452532",
            "telephone_number": "303-724-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF COLORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ASSOCIATE DEAN OF FINANCE ADMINISTR",
        "authorized_official_telephone_number": "303-724-7132",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA,MSHA,CMA"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CO",
            "license": "DR.0055063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09034528",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "School of Dental Medicine, Faculty Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.