NPIMap

Individual provider Active NPI

Pam Bradow, RDH

  • Dental Hygienist
  • Colorado Springs, CO
National Provider Identifier
1790103570
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
000905927 Issued in CO
Practice address
2604 Flintridge Dr
Colorado Springs, CO 80918-4408
Phone
(719) 338-2195
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 000905927 CO Primary

Addresses

Primary practice location

2604 Flintridge Dr
Colorado Springs, CO 80918-4408

Mailing address

2604 Flintridge Dr
Colorado Springs, CO 80918-4408
Phone (719) 338-2195

Other names 1

  • Mrs. Pam Ouren Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000905927COMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Medicaid Dental Home Dental Hygienist Past Accepting new patients
Licensed Dental Hygiene Care Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1790103570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 FLINTRIDGE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184408",
            "telephone_number": "719-338-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 FLINTRIDGE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184408",
            "telephone_number": "719-338-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADOW",
        "first_name": "PAM",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "000905927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAM",
            "last_name": "OUREN",
            "prefix": "MRS.",
            "credential": "DH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.