NPIMap

Organization Active NPI

Colorado Dental Professionals, LLC

  • General Practice Dentistry
  • Fountain, CO
National Provider Identifier
1720171564
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
270 Issued in CO
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Practice address
6980 Mesa Ridge Parkway
Suite 200
Fountain, CO 80817
Phone
(719) 392-4231
Fax
(719) 392-9096
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Authorized official

Name
Brittany N Howard
Title
Cred Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 270 CO Primary

Addresses

Primary practice location

6980 Mesa Ridge Parkway
Suite 200
Fountain, CO 80817

Mailing address

6980 Mesa Ridge Parkway
Suite 200
Fountain, CO 80817
Phone (719) 392-4231

Other names 1

  • Mesa Ridge Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colorado Dental Professionals LLC44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

6980 Mesa Ridge Pkwy
Ste 200
Fountain, CO 80817
Phone (719) 392-4231

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1720171564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6980 MESA RIDGE PARKWAY",
            "address_2": "SUITE 200",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "80817",
            "telephone_number": "719-392-4231",
            "fax_number": "719-392-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6980 MESA RIDGE PARKWAY",
            "address_2": "SUITE 200",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "80817",
            "telephone_number": "719-392-4231",
            "fax_number": "719-392-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CRED COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesa Ridge Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mesa Ridge Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fountain, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.