Pueblo West Dental, Prof.LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PUEBLO WEST DENTAL, PROF.LLC

Doing business as

Pueblo West Neighborhood Dental and Implants

Practice address

120 S Stardust Dr
Pueblo West, CO 81007-1631

Phone

(719) 547-4474

NPI assigned

Jan 3, 2022

Organization subpart

No

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

Authorized official

Name

Taylor Ross, DDSNPI 1528401635

Title

Member

Phone

(303) 263-3902

Specialties & licenses 1

Addresses

Other names 1

• Pueblo West Neighborhood Dental and Implants Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Taylor Randolph Ross

  • General Practice Dentistry
  • Pueblo West, CO
  • NPI 1528401635
  NPD Authorized official

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1891456711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S STARDUST DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810071631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S STARDUST DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810071631",
            "telephone_number": "719-547-4474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S Crescent Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Pueblo West",
            "state": "CO",
            "postal_code": "810072787",
            "country_code": "US",
            "telephone_number": "719-647-9433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PUEBLO WEST DENTAL, PROF.LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "303-263-3902",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pueblo West Neighborhood Dental and Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pueblo Ankle and Foot Care, PLLC
• Pueblo Regional Center
• Pueblo West Assisted Living, LLC (Legacy Commons at Pueblo West)
• Pueblo West Chiropractic Center Inc.
• Pueblo West Chiropractic Health Solutions Inc.
• Pueblo West Gardens
• Pueblo West Metropolitan District
• Pueblo West Neighborhood Dental (Pueblo West Dental Care)
• Pueblo West Primary Care LLC (Pueblo West Primary Care)
• Pure Spa & Wellness

• Dental Clinic/Center in Pueblo West, CO
• Providers in Pueblo West, CO by specialty
• Dental Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.