Colorado Springs Pediatric Dentistry, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

COLORADO SPRINGS PEDIATRIC DENTISTRY, PC

Doing business as

Colorado Springs Pediatric Dentistry

Practice address

1335 Phay Ave Ste C
Canon City, CO 81212-2349

Phone

(719) 522-0123

Fax

(719) 285-8599

NPI assigned

Nov 18, 2020

Organization subpart

Yes

Parent organization

COLORADO SPRINGS PEDIATRIC, PCAs reported in NPPES

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

Authorized official

Name

Cassie Michelle Sears

Title

Practice Manager

Phone

(719) 522-0123

Specialties & licenses 1

Addresses

Other names 1

• Colorado Springs Pediatric Dentistry Doing business as

Tax ID family

Colorado Springs Pediatric Dentistry PC3 organizations share this tax ID, including this one

Part of

Colorado Springs Pediatric Dentistry PC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Colorado Springs Pediatric Dentistry, PC

  dba Colorado Springs Pediatric Dentistry

  • Pediatric Dentistry
  • Colorado Springs, CO
  • NPI 1396348884
  NPD tax ID
• Colorado Springs Pediatric Dentistry, PC

  dba Colorado Springs Pediatric Dentistry

  • Pediatric Dentistry
  • Colorado Springs, CO
  • NPI 1578760302
  NPD tax ID

Locations

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1881297273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9480 BRIAR VILLAGE PT STE 301",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207923",
            "telephone_number": "719-522-0123",
            "fax_number": "719-266-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 PHAY AVE STE C",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122349",
            "telephone_number": "719-522-0123",
            "fax_number": "719-285-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPRINGS PEDIATRIC DENTISTRY, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO SPRINGS PEDIATRIC, PC",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "SEARS",
        "authorized_official_first_name": "CASSIE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "719-522-0123"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado Springs Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colorado Department of Corrections
• Colorado Em-I Medical Services, P.C.
• Colorado Medical Investors, LLC (Canon Lodge Care Center)
• Colorado Mountain Health
• Colorado Springs Dermatology Clinic, P.C.
• Amber Conover
• Eugene Robert Cook, LCSW
• Michal Cooling, CNTP, MNT
• Cornell Corrections of California, Inc.
• Cornell Corrections of California, Inc. (Southern Peaks Regional Center)

• Pediatric Dentistry in Canon City, CO
• Providers in Canon City, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.