NPIMap

Organization Active NPI

Southern Colorado Dental Anesthesiology

  • Dental Clinic/Center
  • Pueblo, CO
National Provider Identifier
1801406434
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SOUTHERN COLORADO DENTAL ANESTHESIOLOGY
Practice address
1225 N Main St Ste 207
Pueblo, CO 81003-2857
Phone
(719) 286-0733
NPI assigned
Aug 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Dr. James Kellan Villalon, DDS, MPHNPI 1851777304
Title
Dentist Anesthesiologist/Owner
Phone
(719) 286-0733

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1225 N Main St Ste 207
Pueblo, CO 81003-2857

Mailing address

1225 N Main St Ste 207
Pueblo, CO 81003-2857

Other names 3

  • Villalon Anesthesiology Doing business as
  • SOCO Dental Anesthesia Other name
  • Southern Colorado Dental Anesthesia Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1596758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1801406434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 N MAIN ST STE 207",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N MAIN ST STE 207",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032857",
            "telephone_number": "719-286-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COLORADO DENTAL ANESTHESIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "VILLALON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "KELLAN",
        "authorized_official_title_or_position": "DENTIST ANESTHESIOLOGIST/OWNER",
        "authorized_official_telephone_number": "719-286-0733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MPH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villalon Anesthesiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOCO Dental Anesthesia",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Southern Colorado Dental Anesthesia",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Southern Colorado Dental Anesthesia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.