NPIMap

Organization Active NPI

Edgewater Modern Dentistry and Orthodontics, LLP

Doing business as Edgewater Modern Dentistry and Orthodontics

  • General Practice Dentistry
  • Edgewater, CO
National Provider Identifier
1780962589
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EDGEWATER MODERN DENTISTRY AND ORTHODONTICS, LLP
Doing business as
Edgewater Modern Dentistry and Orthodontics
Practice address
1921 Sheridan Blvd Ste F
Edgewater, CO 80214-1325
Phone
(303) 202-3550
Fax
(303) 202-3551
NPI assigned
Jul 27, 2011
Last updated
Jul 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Dr. Lauren A Roberts, DDS
Title
Owner Doctor
Phone
(303) 202-3550

Specialties & licenses 1

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

Addresses

Primary practice location

1921 Sheridan Blvd Ste F
Edgewater, CO 80214-1325

Mailing address

2860 Michelle FL 2
Irvine, CA 92606-1008
Phone (714) 368-2077

Other names 1

  • Edgewater Modern Dentistry and Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

1921 Sheridan Blvd
Unit F
Edgewater, CO 80214
Phone (303) 202-3550

Practitioners & affiliated clinicians

Practitioners 8

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": "1311724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1780962589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE FL 2",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061008",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 SHERIDAN BLVD STE F",
            "city": "EDGEWATER",
            "state": "CO",
            "postal_code": "802141325",
            "telephone_number": "303-202-3550",
            "fax_number": "303-202-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWATER MODERN DENTISTRY AND ORTHODONTICS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-27",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "303-202-3550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewater Modern Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edgewater Modern Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgewater, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.