Organization Active NPI

Bear Dental Group Prof. LLC

  • Dental Clinic/Center
  • Lakewood, CO
National Provider Identifier
1780065797
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
9539 Issued in CO
Legal business name
BEAR DENTAL GROUP PROF. LLC
Practice address
10815 W Jewell Ave
Suite L
Lakewood, CO 80232-4851
Phone
(303) 988-6860
Fax
(303) 989-2058
NPI assigned
Jun 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Dr. Jennifer Lee, DDSNPI 1932389574
Title
Owner
Phone
(720) 240-1028

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 9539 CO Primary

Addresses

Primary practice location

10815 W Jewell Ave
Suite L
Lakewood, CO 80232-4851

Mailing address

10815 W Jewell Ave
Suite L
Lakewood, CO 80232-4851
Phone (303) 988-6860

Other identifiers 1

IdentifierTypeStateIssuer
92521258MedicaidCO

National Provider Directory

National Provider Directory

Locations

10815 W Jewell Ave
Ste L
Lakewood, CO 80232
Phone (303) 988-6860

Practitioners & affiliated clinicians

Practitioners 2

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": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1780065797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10815 W JEWELL AVE",
            "address_2": "SUITE L",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802324851",
            "telephone_number": "303-988-6860",
            "fax_number": "303-989-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 W JEWELL AVE",
            "address_2": "SUITE L",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802324851",
            "telephone_number": "303-988-6860",
            "fax_number": "303-989-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR DENTAL GROUP PROF. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-240-1028",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "9539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92521258",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.