Individual provider Active NPI

Maryanne Brooks Butler, DDS,MS

  • Periodontics
  • Parker, CO
National Provider Identifier
1720116676
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8985 Issued in CO
Practice address
10371 Parkglenn Way
Suite #240
Parker, CO 80138-3260
Phone
(720) 851-6050
Fax
(720) 851-6082
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 8985 CO Primary

Addresses

Primary practice location

10371 Parkglenn Way
Suite #240
Parker, CO 80138-3260

Mailing address

10371 Parkglenn Way
Suite #240
Parker, CO 80138-3260
Phone (720) 851-6050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8985COMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Mvpcc PastSince Dec 6, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1720116676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10371 PARKGLENN WAY",
            "address_2": "SUITE #240",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801383260",
            "telephone_number": "720-851-6050",
            "fax_number": "720-851-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10371 PARKGLENN WAY",
            "address_2": "SUITE #240",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801383260",
            "telephone_number": "720-851-6050",
            "fax_number": "720-851-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "MARYANNE",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "8985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.