NPIMap

Organization Active NPI

Mack Family Dental PC

Doing business as Comfort Dental Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Centennial, CO
National Provider Identifier
1912678608
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
MACK FAMILY DENTAL PC
Doing business as
Comfort Dental Oral Surgery
Practice address
15250 E. Orchard Rd.
Centennial, CO 80016
Phone
(303) 690-5037
Fax
(720) 640-0550
NPI assigned
Sep 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Eric L Mack, DDSNPI 1861464018
Title
Owner
Phone
(303) 690-5037

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

15250 E. Orchard Rd.
Centennial, CO 80016

Mailing address

15250 E. Orchard Rd.
Centennial, CO 80016
Phone (303) 690-5037

Other names 1

  • Comfort Dental Oral Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comfort Dental Oral Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1912678608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15250 E. ORCHARD RD.",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80016",
            "telephone_number": "303-690-5037",
            "fax_number": "720-640-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15250 E. ORCHARD RD.",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80016",
            "telephone_number": "303-690-5037",
            "fax_number": "720-640-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-690-5037",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Dental Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Comfort Dental Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.