NPIMap

Organization Active NPI

Greeley Modern Dentistry, LLP

Doing business as Greeley Modern Dentistry

  • General Practice Dentistry
  • Greeley, CO
National Provider Identifier
1750678439
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GREELEY MODERN DENTISTRY, LLP
Doing business as
Greeley Modern Dentistry
Practice address
6632 10TH Street Suite 101
Greeley, CO 80634
Phone
(970) 353-4848
Fax
(970) 356-5752
NPI assigned
Jul 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Dr. Charles F Rodgers, DDS
Title
Owner Doctor
Phone
(970) 353-4848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6632 10TH Street Suite 101
Greeley, CO 80634

Mailing address

2860 Michelle FL 2
Irvine, CA 92606-1008
Phone (714) 368-2077

Other names 1

  • Greeley Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

6632 W 10th St
Ste 101
Greeley, CO 80634
Phone (970) 353-4848

Practitioners & affiliated clinicians

Practitioners 12

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": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1750678439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE FL 2",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061008",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6632 10TH STREET SUITE 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-353-4848",
            "fax_number": "970-356-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREELEY MODERN DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "970-353-4848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greeley Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.