4 Corners Dental Sleep Solutions LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

4 CORNERS DENTAL SLEEP SOLUTIONS LLC

Practice address

302 W Montezuma Ave
Cortez, CO 81321-2750

Phone

(970) 565-3612

NPI assigned

Apr 24, 2019

Last updated

Jun 10, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

4 CORNERS DENTAL SLEEP SOLUTIONS LLCAs reported in NPPES

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

Authorized official

Name

Dr. John A Vestal, DDSNPI 1417940727

Title

Owner

Phone

(970) 565-3612

Specialties & licenses 1

Addresses

Part of

4 Corners Dental Sleep Solutions LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Alton Vestal III, D.D.S.

  • Dentist
  • Cortez, CO
  • NPI 1417940727

  Durable Medical Equipment & Medical Supplies

  NPD Authorized official

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560124800000",
    "number": "1902460017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W MONTEZUMA AVE",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MONTEZUMA AVE",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212750",
            "telephone_number": "970-565-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4 CORNERS DENTAL SLEEP SOLUTIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "4 CORNERS DENTAL SLEEP SOLUTIONS LLC",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-06-10",
        "status": "A",
        "authorized_official_last_name": "VESTAL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-565-3612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Cortez, CO
• Providers in Cortez, CO by specialty
• Durable Medical Equipment & Medical Supplies in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.