Broomfield Dental Group, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BROOMFIELD DENTAL GROUP, LLC

Doing business as

Broomfield Dental Group

Practice address

1140 U.S. Hwy 287
Suite 200
Broomfield, CO 80020-7076

Phone

(303) 438-9899

Fax

(216) 584-1350

NPI assigned

Oct 27, 2006

Last updated

Mar 20, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

DENTALONE PARTNERS, INCAs reported in NPPES

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

Authorized official

Name

Rachel Nittinger

Title

Manager Credentialing

Phone

(972) 755-0816

Specialties & licenses 7

Addresses

Other names 1

• Broomfield Dental Group Doing business as

Locations

Practitioners 5

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.

• Javan David Houser, DDS

  • Dentist
  • Falcon, CO
  • NPI 1114935251
  NPD (past)
• Kendra Luey, RDH

  • Dental Hygienist
  • Broomfield, CO
  • NPI 1508088782
  NPD (past)
• Nichole Noetzelman

  • Dental Hygienist
  • Broomfield, CO
  • NPI 1356578868
  NPD (past)
• Gayle Phillips

  • Dental Hygienist
  • Broomfield, CO
  • NPI 1336360478
  NPD (past)
• Dawn Jimenez Wehking, DDS

  • General Practice Dentistry
  • Broomfield, CO
  • NPI 1508170895
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1750467585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 DALLAS PKWY STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 U.S. HWY 287",
            "address_2": "SUITE 200",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207076",
            "telephone_number": "303-438-9899",
            "fax_number": "216-584-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOMFIELD DENTAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTALONE PARTNERS, INC",
        "enumeration_date": "2006-10-27",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "NITTINGER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "MANAGER CREDENTIALING",
        "authorized_official_telephone_number": "972-755-0816"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broomfield Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Alan Britt
• Broadlands Family Dentistry General Partnership
• Brooke Lundy Fleischmann, DDS, PC
• Kate Mullany Brooks, DH
• Broomfield Dental Care PC
• Broomfield Diagnostics LLC
• Broomfield Huron Medical Center, LLC (UCHealth Emergency Room)
• Broomfield Medical Associates PC
• Broomfield Modern Dentistry and Orthodontics, LLP (Broomfield Modern Dentistry and Orthodontics)
• Broomfield Orthopedic Surgery Center, LLC (Broomfield Orthopedic Recovery Center)

• General Practice Dentistry in Broomfield, CO
• Providers in Broomfield, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.