NPIMap

Organization Active NPI

Edward J. Bertagnolli, DDS, PC

  • Dentist
  • Westminster, CO
National Provider Identifier
1952708877
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
HDL00161 Issued in CO
Legal business name
EDWARD J. BERTAGNOLLI, DDS, PC
Practice address
7280 Bradburn Blvd.
Westminster, CO 80030
Phone
(303) 429-6222
Fax
(303) 429-7247
NPI assigned
Nov 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Authorized official

Name
John O. Bertagnolli, DDS.NPI 1881881795
Title
Dentist
Phone
(303) 429-6222

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X HDL00161 CO Primary

Addresses

Primary practice location

7280 Bradburn Blvd.
Westminster, CO 80030

Mailing address

7280 Bradburn Blvd.
Westminster, CO 80030
Phone (303) 429-6222

Other identifiers 1

IdentifierTypeStateIssuer
51424215MedicaidCO

National Provider Directory

National Provider Directory

Locations

7280 Bradburn Blvd
Westminster, CO 80030
Phone (303) 429-6222

Practitioners & affiliated clinicians

Practitioners 5

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": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1952708877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7280 BRADBURN BLVD.",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "80030",
            "telephone_number": "303-429-6222",
            "fax_number": "303-429-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7280 BRADBURN BLVD.",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "80030",
            "telephone_number": "303-429-6222",
            "fax_number": "303-429-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD J. BERTAGNOLLI, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "BERTAGNOLLI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "303-429-6222",
        "authorized_official_credential": "DDS."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "HDL00161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51424215",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.