Pediatric Dental Group of Lakewood

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PEDIATRIC DENTAL GROUP OF LAKEWOOD

Practice address

3333 S Wadsworth Blvd Unit B104
Lakewood, CO 80227-5120

Phone

(303) 984-9700

Fax

(303) 985-2490

NPI assigned

Jun 5, 2009

Organization subpart

No

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

Authorized official

Name

Nicole E Hartshorn

Title

Office Manager

Phone

(720) 338-9778

Specialties & licenses 3

Addresses

Other identifiers 5

Locations

Practitioners 1

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

• Justin W Cathers, DDS MS

  • Pediatric Dentistry
  • Lakewood, CO
  • NPI 1760505440
  NPD

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1720214638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S WADSWORTH BLVD UNIT B102B104",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802275122",
            "telephone_number": "303-984-9700",
            "fax_number": "303-985-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S WADSWORTH BLVD UNIT B104",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802275120",
            "telephone_number": "303-984-9700",
            "fax_number": "303-985-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL GROUP OF LAKEWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "HARTSHORN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "720-338-9778"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44332866",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02006518",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02078434",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38371847",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83777709",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doreen B Pearce, MD
• Jennifer Bavaria Pearson, LPC
• Leslie M Pearson, MD
• Darby Jane Pedersen, ND
• Pediatric Dental Group at Kids First
• Pediatrix Primary Care of Colorado, PLLC
• Pediatrix Urgent Care of Colorado, PLLC
• Pedo Lakewood LLC
• Pedo Two, Prof. LLC
• Shannon Peistrup

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.