NPIMap

Organization Active NPI

My Local Colorado Dental Practice, LLC

  • General Practice Dentistry
  • Westminster, CO
National Provider Identifier
1952941650
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Practice address
12031 Tejon St Ste 100
Westminster, CO 80234-2306
Phone
(303) 451-1111
NPI assigned
Jan 10, 2020
Organization subpart
Yes
Parent organization
MY LOCAL COLORADO DENTAL PRACTICE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Michelle Johnson
Title
Credentialing Specialist
Phone
(509) 315-8338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

12031 Tejon St Ste 100
Westminster, CO 80234-2306

Mailing address

12031 Tejon St Ste 100
Westminster, CO 80234-2306

Other names 1

  • Mile High Dental and Implant Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
My Local Colorado Dental Practice LLC40 organizations share this tax ID, including this one
Part of
My Local Colorado Dental Practice LLC

Other organizations with this tax ID 39

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

View all 39

Locations

12031 Tejon St
Ste 100
Westminster, CO 80234
Phone (303) 451-1111

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1952941650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12031 TEJON ST STE 100",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12031 TEJON ST STE 100",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342306",
            "telephone_number": "303-451-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY LOCAL COLORADO DENTAL PRACTICE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY LOCAL COLORADO DENTAL PRACTICE, LLC",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "509-315-8338"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mile High Dental and Implant Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 10, 2020; 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.