Ideal Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00202682 Issued in CO

Legal business name

IDEAL DENTAL PLLC

Practice address

1835 S Federal Blvd
Denver, CO 80219-4953

Phone

(720) 336-8251

NPI assigned

Dec 22, 2016

Last updated

Dec 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victor PerezNPI 1760852917

Title

DDS

Phone

(818) 261-2514

Specialties & licenses 2

Addresses

Locations

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.

• Victor Eduardo Perez, DDS

  • Periodontics
  • Rancho Cucamonga, CA
  • NPI 1760852917
  Authorized official Same address or phone

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1821533183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 S FEDERAL BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802194953",
            "telephone_number": "720-336-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 S FEDERAL BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802194953",
            "telephone_number": "720-336-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-22",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "818-261-2514"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202682",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00202682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Elizabeth Ickes, D.O.
• Becca Ickowicz
• Icon Dental
• Therese Ann Ida, R.D.
• Idea Forum Inc.
• Chelsea Marie Ideker, MSOTR/L
• Identity Hormones Co LLC (Identity Hormones Denver)
• Ies Colorado PLLC
• Ies Obs Colorado PLLC
• Cristos Ifantides, M.D.

• General Practice Dentistry in Denver, CO
• Providers in Denver, 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 Dec 22, 2016; 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.