Christina Marie Mazzola, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN-9952 Issued in CO

Practice address

1930 S Nevada Ave
Colorado Springs, CO 80905-3407

Phone

(719) 576-5566

NPI assigned

Jun 17, 2009

Last updated

Apr 20, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Traverse Dental Associates, PLLC

  • General Practice Dentistry
  • Traverse City, MI
  • NPI 1336171800
  Medicare reassignment
• Broadmoor Dental, LLC

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1295037646
  NPD (past)
• Colorado Dental Professionals, LLC

  dba Broadmoor Dental

  • Dentist
  • Colorado Springs, CO
  • NPI 1093456857
  NPD (past)

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1811124894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4565 IRON ORE LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809067602",
            "telephone_number": "231-392-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809053407",
            "telephone_number": "719-576-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOLA",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN-9952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianne Rose Maze, RBT
• Katherine S Maziar, MD
• Ashley Maziarski
• Shawna Marie Mazurek, QRTP
• Erica Mazzarelli, DPT
• Christopher Daniel Mazzola, D.D.S.
• Deirdre Raquel McAdams, AGNP
• Labrea McAdams, RBT
• Victoria D McAdams, CNS, APN
• Deborah A. McAdoo, L.M.F.T.

• General Practice Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.