Individual provider Active NPI

John O Bertagnolli, D.D.S.

  • General Practice Dentistry
  • Westminster, CO
National Provider Identifier
1881881795
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8128 Issued in CO
Practice address
7280 Bradburn Blvd
Westminster, CO 80030-5224
Phone
(303) 429-6222
NPI assigned
Sep 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8128 CO Primary

Addresses

Primary practice location

7280 Bradburn Blvd
Westminster, CO 80030-5224

Mailing address

7280 Bradburn Blvd
Westminster, CO 80030-5224
Phone (303) 429-6222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8128COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Edward J. Bertagnolli, DDS, PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1881881795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7280 BRADBURN BLVD",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800305224",
            "telephone_number": "303-429-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7280 BRADBURN BLVD",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800305224",
            "telephone_number": "303-429-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTAGNOLLI",
        "first_name": "JOHN",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.