NPIMap

Organization Active NPI

Jennifer K Hargleroad DDS Ms Professional LLC

  • Pediatric Dentistry
  • Fort Collins, CO
National Provider Identifier
1801277926
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8365 Issued in CO
Legal business name
JENNIFER K HARGLEROAD DDS MS PROFESSIONAL LLC
Practice address
2105 Bighorn Rd
Suite 202
Fort Collins, CO 80525-3555
Phone
(970) 232-9097
NPI assigned
Jun 15, 2015
Last updated
Jun 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Jennifer Kay Hargleroad, DDS MSNPI 1992894562
Title
Owner Member
Phone
(970) 493-2254

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 8365 CO Primary

Addresses

Primary practice location

2105 Bighorn Rd
Suite 202
Fort Collins, CO 80525-3555

Mailing address

2105 Bighorn Rd
Suite 202
Fort Collins, CO 80525-3555
Phone (970) 232-9097

Other identifiers 2

IdentifierTypeStateIssuer
54182336MedicaidCO
78907811MedicaidCO

National Provider Directory

National Provider Directory

Locations

2105 Bighorn Rd
Ste 202
Fort Collins, CO 80525
Phone (970) 232-9097

Practitioners & affiliated clinicians

Practitioners 1

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": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1801277926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BIGHORN RD",
            "address_2": "SUITE 202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253555",
            "telephone_number": "970-232-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BIGHORN RD",
            "address_2": "SUITE 202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253555",
            "telephone_number": "970-232-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER K HARGLEROAD DDS MS PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "HARGLEROAD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER MEMBER",
        "authorized_official_telephone_number": "970-493-2254",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "8365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54182336",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78907811",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.