Ncdi Drake, Professional LLP

Key facts

NPI

1730635178

Entity type

Organization (NPI type 2)

Primary specialty

Pediatric Dentistry 1223P0221X

Legal business name

NCDI DRAKE, PROFESSIONAL LLP

Practice address

383 W Drake Rd
Suite 103
Fort Collins, CO 80526-2884

Phone

(970) 223-8687

Fax

(970) 207-1971

NPI assigned

Aug 26, 2016

Organization subpart

Yes

Parent organization (as reported)

SVC DENTAL GROUP, PROFESSIONAL LLP

Authorized official

Name

Katie Hambright

Title

Office Manager

Phone

(970) 223-8687

National Provider Directory

Part of

SVC Dental Group LLC

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 26, 2016.

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1730635178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 W DRAKE RD",
            "address_2": "SUITE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262884",
            "telephone_number": "970-223-8687",
            "fax_number": "970-207-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 W DRAKE RD",
            "address_2": "SUITE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262884",
            "telephone_number": "970-223-8687",
            "fax_number": "970-207-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NCDI DRAKE, PROFESSIONAL LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SVC DENTAL GROUP, PROFESSIONAL LLP",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "HAMBRIGHT",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-223-8687"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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