Perfect Teeth - Garden of the Gods P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6097 Issued in CO

Legal business name

PERFECT TEETH - GARDEN OF THE GODS P.C.

Doing business as

Perfect Teeth - Garden of the Gods P.C.

Practice address

4329 Centennial Blvd
Colorado Springs, CO 80907-3769

Phone

(719) 592-1600

Fax

(719) 592-1120

NPI assigned

Apr 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurie Summers

Title

Credentialing

Phone

(303) 285-6098

Specialties & licenses 1

Addresses

Other names 1

• Perfect Teeth - Garden of the Gods P.C. 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, and the practitioner matching its NPPES authorized official.

• Danielle D Coval, DDS

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1205080751
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770604449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4329 CENTENNIAL BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073769",
            "telephone_number": "719-592-1600",
            "fax_number": "719-592-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4329 CENTENNIAL BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073769",
            "telephone_number": "719-592-1600",
            "fax_number": "719-592-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT TEETH - GARDEN OF THE GODS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "303-285-6098"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perfect Teeth - Garden of the Gods P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, 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 Aug 22, 2020; 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.