NPIMap

Organization Active NPI

Kellogg-Paisley LLC

  • Dentist
  • Brighton, CO
National Provider Identifier
1740440205
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8690 Issued in CO
Legal business name
KELLOGG-PAISLEY LLC
Practice address
4700 E Bromley LN
Suite 201
Brighton, CO 80601-7820
Phone
(303) 659-0667
Fax
(303) 659-5247
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Dr. Bradley Scott Kellogg, DDSNPI 1629145750
Title
Dentist/Manager
Phone
(303) 659-0667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 8690 CO Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 8744 CO

Addresses

Primary practice location

4700 E Bromley LN
Suite 201
Brighton, CO 80601-7820

Mailing address

4700 E Bromley LN
Suite 201
Brighton, CO 80601-7820
Phone (303) 659-0667

Other identifiers 1

IdentifierTypeStateIssuer
44234228MedicaidCO

Other names 1

  • Bromley Park Dental Doing business as

National Provider Directory

National Provider Directory

Locations

4700 E Bromley Ln
Ste 201
Brighton, CO 80601
Phone (303) 659-0667

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1740440205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 E BROMLEY LN",
            "address_2": "SUITE 201",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806017820",
            "telephone_number": "303-659-0667",
            "fax_number": "303-659-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 E BROMLEY LN",
            "address_2": "SUITE 201",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806017820",
            "telephone_number": "303-659-0667",
            "fax_number": "303-659-5247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLOGG-PAISLEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "KELLOGG",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "DENTIST/MANAGER",
        "authorized_official_telephone_number": "303-659-0667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "8690",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44234228",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bromley Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.