Ponderosa Family Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PONDEROSA FAMILY DENTAL

Practice address

307 W Winnie LN Ste 2
Carson City, NV 89703-2145

Phone

(775) 885-2323

NPI assigned

Sep 30, 2021

Last updated

Sep 30, 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

Aleta Beuter

Title

Credentialing Specialist

Phone

(775) 409-4614

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 3

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.

• Jared A Walker

  • General Practice Dentistry
  • Carson City, NV
  • NPI 1437762556
  NPD
• Russell S Curtis, DMD

  • General Practice Dentistry
  • Carson City, NV
  • NPI 1386761633
  NPD (past)
• Saman Nicholas Hashtroudi, DMD

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1740520188
  NPD (past)

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632960000000",
    "number": "1730851429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 GRANT DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895095301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W WINNIE LN STE 2",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897032145",
            "telephone_number": "775-885-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONDEROSA FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A",
        "authorized_official_last_name": "BEUTER",
        "authorized_official_first_name": "ALETA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "775-409-4614"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO OTHER",
            "identifier": "000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aleta@bluetreedental.com",
            "affiliation": "N",
            "address_1": "307 W Winnie Ln Ste 2",
            "city": "Carson City",
            "state": "NV",
            "country_code": "US",
            "postal_code": "897032145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James William Pittman Jr., OD
• Mytasia Plew
• Dora Arleen Polintang
• Yazmin Polvorosa
• Emanuella Pomerlyan
• Angelica Poole, RN
• Curtis Alexander Pope, COTA
• Paisley Pope
• Jason Porras, LCSW
• Brennan Pott

• Dentist in Carson City, NV
• Providers in Carson City, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.