NPIMap

Organization Active NPI

Professional Dental Care of Central Colorado I PLLC

  • Dental Clinic/Center
  • Parker, CO
National Provider Identifier
1790394138
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PROFESSIONAL DENTAL CARE OF CENTRAL COLORADO I PLLC
Doing business as
Creekside Dental
Practice address
13097 S Parker Rd Unit a
Parker, CO 80134-7447
Phone
(303) 841-0549
Fax
(303) 841-0538
NPI assigned
Jul 30, 2020
Organization subpart
Yes
Parent organization
SSUN HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Cary Lacouture, DDS
Title
Owner
Phone
(303) 841-0549

Specialties & licenses 1

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

Addresses

Primary practice location

13097 S Parker Rd Unit a
Parker, CO 80134-7447

Mailing address

10940 S Parker Rd Ste 121
Parker, CO 80134-7440
Phone (303) 841-0549

Other names 1

  • Creekside Dental Doing business as

National Provider Directory

National Provider Directory
Part of
Ssun Health LLC

Locations

13097 S Parker Rd
Unit A
Parker, CO 80134
Phone (303) 841-0549

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": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1790394138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10940 S PARKER RD STE 121",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347440",
            "telephone_number": "303-841-0549",
            "fax_number": "303-841-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13097 S PARKER RD UNIT A",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347447",
            "telephone_number": "303-841-0549",
            "fax_number": "303-841-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL CARE OF CENTRAL COLORADO I PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSUN HEALTH, LLC",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "LACOUTURE",
        "authorized_official_first_name": "CARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-841-0549",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekside Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.