Ideal Dental Erie PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

IDEAL DENTAL ERIE PLLC

Practice address

680 Mitchell Way Unit 170
Erie, CO 80516-5452

Phone

(972) 361-0600

NPI assigned

Mar 6, 2023

Organization subpart

No

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

Authorized official

Name

Rodney Alles

Title

Owner

Phone

(972) 361-0600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1841990108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840925",
            "telephone_number": "972-361-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 MITCHELL WAY UNIT 170",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805165452",
            "telephone_number": "972-361-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL ERIE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "ALLES",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-361-0600"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.