NPIMap

Organization Active NPI

Green Mountain LLC

  • Dental Clinic/Center
  • Idaho Springs, CO
National Provider Identifier
1851778641
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
00202483 Issued in CO
Legal business name
GREEN MOUNTAIN LLC
Practice address
1625 Miner Street
Idaho Springs, CO 80452
Phone
(716) 472-5745
NPI assigned
Apr 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Dr. Joshua W Ricks, DDS
Title
Owner/Dentist
Phone
(716) 472-5745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 00202483 CO Primary

Addresses

Primary practice location

1625 Miner Street
Idaho Springs, CO 80452

Mailing address

PO Box 277
Idaho Springs, CO 80452-0277
Phone (716) 472-5745

Other names 1

  • Ricks Family Dental Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1851778641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "IDAHO SPRINGS",
            "state": "CO",
            "postal_code": "804520277",
            "telephone_number": "716-472-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 MINER STREET",
            "city": "IDAHO SPRINGS",
            "state": "CO",
            "postal_code": "80452",
            "telephone_number": "716-472-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MOUNTAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "716-472-5745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "00202483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ricks Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.