Organization Active NPI

My Dentist Inc.

  • General Practice Dentistry
  • Thornton, CO
National Provider Identifier
1861663668
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10-4900 Issued in CO
Legal business name
MY DENTIST INC.
Practice address
3955 E 120TH Ave Ste B
Thornton, CO 80233-2075
Phone
(303) 255-4855
Fax
(303) 339-7912
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Dr. Gregory Krainik, DDS
Title
Owner
Phone
(303) 255-4855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 10-4900 CO Primary

Addresses

Primary practice location

3955 E 120TH Ave Ste B
Thornton, CO 80233-2075

Mailing address

3955 E 120TH Ave Ste B
Thornton, CO 80233-2075
Phone (303) 255-4855

Other identifiers 1

IdentifierTypeStateIssuer
4947TOtherNVSTATE LICSENCE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1861663668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 E 120TH AVE STE B",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802332075",
            "telephone_number": "303-255-4855",
            "fax_number": "303-339-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 E 120TH AVE STE B",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802332075",
            "telephone_number": "303-255-4855",
            "fax_number": "303-339-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DENTIST INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "KRAINIK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-255-4855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10-4900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICSENCE",
            "identifier": "4947T",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.