Denterus Dental Lab

Primary specialty

DentistTaxonomy code 122300000X

License

00201875 Issued in CO

Legal business name

DENTERUS DENTAL LAB

Practice address

3208 N Academy Blvd
Suite 140
Colorado Springs, CO 80917-5161

Phone

(719) 301-5300

Fax

(719) 301-5303

NPI assigned

Dec 31, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Michael Robert Bull, DDS

Title

Owner

Phone

(719) 301-5300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451520000000",
    "number": "1790140010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3208 N ACADEMY BLVD",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175161",
            "telephone_number": "719-301-5300",
            "fax_number": "719-301-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 N ACADEMY BLVD",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175161",
            "telephone_number": "719-301-5300",
            "fax_number": "719-301-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTERUS DENTAL LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-31",
        "last_updated": "2015-12-31",
        "status": "A",
        "authorized_official_last_name": "BULL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-301-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "00201875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Arts Center
• Dental Health Professionals of Colorado
• Dental Holdings, P.C., Dba Mountain Shadows Family Dentistry
• Dental Nook at Red Rock Canyon PLLC
• Dental Specialty Center of Colorado Springs PLLC
• Dentifferent Solutions, Prof., LLC
• Dentistry in the Forest
• Dentists of Broadmoor, LLP
• Dentists of Centennial and Orthodontics LLP
• Dentists of Interquest and Orthodontics

• Dentist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Dentist in Colorado

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