NPIMap

Organization Active NPI

Colorado Dental Professionals, LLC

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1962059931
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Doing business as
Southpointe Complete Dental
Practice address
655 Southpointe CT Ste 150
Colorado Springs, CO 80906-3859
Phone
(719) 527-9098
NPI assigned
Aug 23, 2019
Organization subpart
Yes
Parent organization
COLORADO DENTAL PROFESSIONALS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Authorized official

Name
Hannah Fish
Title
Credentialing Manager
Phone
(217) 540-5699

Specialties & licenses 1

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

Addresses

Primary practice location

655 Southpointe CT Ste 150
Colorado Springs, CO 80906-3859

Mailing address

655 Southpointe CT Ste 150
Colorado Springs, CO 80906-3859

Other names 1

  • Southpointe Complete Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colorado Dental Professionals LLC44 organizations share this tax ID, including this one
Part of
Colorado Dental Professionals LLC

Other organizations with this tax ID 43

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

View all 43

Locations

655 Southpointe Ct
Ste 150
Colorado Springs, CO 80906
Phone (719) 527-9098

NPI Registry JSON

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1962059931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 SOUTHPOINTE CT STE 150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 SOUTHPOINTE CT STE 150",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063859",
            "telephone_number": "719-527-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO DENTAL PROFESSIONALS, LLC",
        "enumeration_date": "2019-08-23",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5699"
    },
    "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": "Southpointe Complete Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southpointe Complete Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.