NPIMap

Organization Active NPI

Treasured Teeth PC

  • Pediatric Dentistry
  • Montrose, CO
National Provider Identifier
1922247758
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9579 Issued in CO
Legal business name
TREASURED TEETH PC
Practice address
100 Tessitore CT Unit C
Montrose, CO 81401-5689
Phone
(970) 240-8694
Fax
(970) 240-8696
NPI assigned
Feb 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Authorized official

Name
Dr. Derren Elvis Tippets, DMD
Title
Owner, Pediatric Dentist
Phone
(970) 240-8694

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 9579 CO Primary

Addresses

Primary practice location

100 Tessitore CT Unit C
Montrose, CO 81401-5689

Mailing address

100 Tessitore CT Unit C
Montrose, CO 81401-5689
Phone (970) 240-8694

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1922247758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TESSITORE CT UNIT C",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015689",
            "telephone_number": "970-240-8694",
            "fax_number": "970-240-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TESSITORE CT UNIT C",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015689",
            "telephone_number": "970-240-8694",
            "fax_number": "970-240-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURED TEETH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "TIPPETS",
        "authorized_official_first_name": "DERREN",
        "authorized_official_middle_name": "ELVIS",
        "authorized_official_title_or_position": "OWNER, PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "970-240-8694",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "9579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.