Promenade Dentist Office and Orthodontics, LLP

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PROMENADE DENTIST OFFICE AND ORTHODONTICS, LLP

Doing business as

Promenade Dentist Office and Orthodontics

Practice address

5715 Atrium Drive
Suite 130
Castle Rock, CO 80108-1927

Phone

(720) 805-2425

NPI assigned

Dec 29, 2021

Last updated

Dec 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason D Conrad, DDS

Title

Owner

Phone

(720) 805-2425

Specialties & licenses 1

Addresses

Other names 1

• Promenade Dentist Office and Orthodontics Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kamran Waterman, DMD

  • Dentist
  • Castle Rock, CO
  • NPI 1154006302
  NPD
• Raymond Joseph Hatzenbeller III, DDS

  • General Practice Dentistry
  • Castle Rock, CO
  • NPI 1255262002
  NPD (past)

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1720748999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 ATRIUM DRIVE",
            "address_2": "SUITE 130",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801081927",
            "telephone_number": "720-805-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMENADE DENTIST OFFICE AND ORTHODONTICS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-805-2425",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promenade Dentist Office and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Terasa Alaine Prince, LAC, NCC
• Stuart M Prins, MD
• Priority Medical Supply, LLC
• Prisma Dimensions Group, LLC
• Prisma Dimensions Group, LLC
• Promise Ranch Therapeutic Riding
• Promise Ranch Therapeutic Riding
• Courtney Pronin
• Hanna Brooke Pruss
• Ashlee Rebecca Pulver, PMHNP

• Dentist in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.