NPIMap

Organization Active NPI

Crested Oak Dentistry PLLC

  • General Practice Dentistry
  • Grand Junction, CO
National Provider Identifier
1780287235
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CRESTED OAK DENTISTRY PLLC
Practice address
2532 Patterson Rd Ste 1
Grand Junction, CO 81505-3607
Phone
(970) 241-4800
Fax
(970) 241-8266
NPI assigned
Nov 18, 2020
Last updated
Nov 18, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CRESTED OAK DENTISTRY PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Tammy Echer
Title
General Manager
Phone
(970) 241-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2532 Patterson Rd Ste 1
Grand Junction, CO 81505-3607

Mailing address

2532 Patterson Rd Ste 1
Grand Junction, CO 81505-3607
Phone (970) 214-4800

Other practice location 1

102 Main St Ste 100
Delta, CO 81416-1873
Phone (970) 874-3855

National Provider Directory

National Provider Directory
Tax ID family
Crested Oak Dentistry PLLC2 organizations share this tax ID, including this one
Part of
Crested Oak Dentistry PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 Main St
Ste 100
Delta, CO 81416
Phone (970) 874-3855

2532 Patterson Rd
Ste 1
Grand Junction, CO 81505
Phone (970) 241-4800

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1780287235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 PATTERSON RD STE 1",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815053607",
            "telephone_number": "970-214-4800",
            "fax_number": "970-241-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 PATTERSON RD STE 1",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815053607",
            "telephone_number": "970-241-4800",
            "fax_number": "970-241-8266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Delta",
            "state": "CO",
            "postal_code": "814161873",
            "country_code": "US",
            "telephone_number": "970-874-3855",
            "fax_number": "970-874-7186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CRESTED OAK DENTISTRY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRESTED OAK DENTISTRY PLLC",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "ECHER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "970-241-4800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.