NPIMap

Organization Active NPI

Pagosa Dental Care PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Pagosa SPGS, CO
National Provider Identifier
1770018830
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DEN00008224 Issued in CO
Legal business name
PAGOSA DENTAL CARE PC
Practice address
189 Talisman Dr
Ste E
Pagosa SPGS, CO 81147-7916
Phone
(970) 731-6600
NPI assigned
Apr 26, 2017
Last updated
Apr 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Authorized official

Name
William ThornellNPI 1396841326
Title
Owner
Phone
(970) 731-6600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DEN00008224 CO Primary

Addresses

Primary practice location

189 Talisman Dr
Ste E
Pagosa SPGS, CO 81147-7916

Mailing address

189 Talisman Dr
Ste E
Pagosa SPGS, CO 81147-7916

National Provider Directory

National Provider Directory

Locations

189 Talisman Dr
Ste E
Pagosa Springs, CO 81147
Phone (970) 731-6600

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1770018830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 TALISMAN DR",
            "address_2": "STE E",
            "city": "PAGOSA SPGS",
            "state": "CO",
            "postal_code": "811477916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 TALISMAN DR",
            "address_2": "STE E",
            "city": "PAGOSA SPGS",
            "state": "CO",
            "postal_code": "811477916",
            "telephone_number": "970-731-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGOSA DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "THORNELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-731-6600"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "DEN00008224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pagosa SPGS, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.