Merritt Periodontics P.C.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

8786 Issued in CO

Legal business name

MERRITT PERIODONTICS P.C.

Practice address

1120 East Elizabeth Street
Suite G5
Fort Collins, CO 80524-4044

Phone

(970) 221-5050

Fax

(970) 221-5054

NPI assigned

Apr 24, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Jennifer R. Merritt, D.D.S.

Title

Owner

Phone

(970) 221-5050

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Associates in Periodontics Doing business as

Locations

Practitioners 1

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

• David Clark Johnson, DDS, MS

  • Periodontics
  • Fort Collins, CO
  • NPI 1194788141
  NPD (past)

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1760802102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 EAST ELIZABETH STREET",
            "address_2": "SUITE G5",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244044",
            "telephone_number": "970-221-5050",
            "fax_number": "970-221-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 EAST ELIZABETH STREET",
            "address_2": "SUITE G5",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244044",
            "telephone_number": "970-221-5050",
            "fax_number": "970-221-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRITT PERIODONTICS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-221-5050",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "8786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DENTAL LICENSE DR. MERRITT",
            "identifier": "9625",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DENTAL LICENSE DR. JOHNSON",
            "identifier": "8786",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associates in Periodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Associates in Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Kay Mercurio, RN, BSN
• Randy Mergler, M.S., LMFT
• Sarah Mericle, LMT
• Craig Merrill, LPC, CAS, MA
• Leslie Ann Merriman, M.S.
• Jason Lee Merritt, MD
• Morgan Marie Merritt, LSW
• Stacy Rene Merritt, RN
• Susan Lynn Mertz
• Brian Mesinger, PSYCHOLOGIST

• Periodontics in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Periodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.