Individual provider Active NPI

Terry Alan Tedford, DDS

  • Dentist
  • Centennial, CO
National Provider Identifier
1740272293
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
05155 Issued in CO
Practice address
7562 S University Blvd
Ste J
Centennial, CO 80122-3159
Phone
(303) 770-8278
Fax
(303) 770-8279
NPI assigned
Aug 19, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 05155 CO Primary

Addresses

Primary practice location

7562 S University Blvd
Ste J
Centennial, CO 80122-3159

Mailing address

7265 S University Blvd
Ste J
Centennial, CO 80122
Phone (303) 770-8278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150603002487 CO Order and Referring Only - DentistPractitioner - Dentist 0941521827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05155COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Dental Care PLLC PastSince Nov 28, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740272293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7265 S UNIVERSITY BLVD",
            "address_2": "STE J",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80122",
            "telephone_number": "303-770-8278",
            "fax_number": "303-770-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7562 S UNIVERSITY BLVD",
            "address_2": "STE J",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801223159",
            "telephone_number": "303-770-8278",
            "fax_number": "303-770-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDFORD",
        "first_name": "TERRY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "05155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.