NPIMap

Organization Active NPI

Jennifer L Unger Waters DDS PC

Doing business as Clear Creek Dental Clinic

  • Dental Clinic/Center
  • Golden, CO
National Provider Identifier
1952510679
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
8005 Issued in CO
Legal business name
JENNIFER L UNGER WATERS DDS PC
Doing business as
Clear Creek Dental Clinic
Practice address
1600 Washington Ave
Golden, CO 80401-1927
Phone
(303) 279-6621
Fax
(303) 216-0278
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Dr. Jennifer Unger Waters, DDSNPI 1588647176
Title
President/Owner
Phone
(303) 279-6621

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
Dental Clinic/Center 261QD0000X 8005 CO Primary

Addresses

Primary practice location

1600 Washington Ave
Golden, CO 80401-1927

Mailing address

1600 Washington Ave
Golden, CO 80401-1927
Phone (303) 279-6621

Other identifiers 1

IdentifierTypeStateIssuer
1588647176OtherCONPI

Other names 1

  • Clear Creek Dental Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

1607 Washington Ave
Golden, CO 80401
Phone (303) 279-6621

1600 Washington Ave
Golden, CO 80401
Phone (303) 279-6621

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1952510679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WASHINGTON AVE",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804011927",
            "telephone_number": "303-279-6621",
            "fax_number": "303-216-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WASHINGTON AVE",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804011927",
            "telephone_number": "303-279-6621",
            "fax_number": "303-216-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER L UNGER WATERS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "UNGER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "303-279-6621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "8005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1588647176",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Creek Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.