NPIMap

Organization Active NPI

Montrose Dental PLLC

  • General Practice Dentistry
  • Montrose, CO
National Provider Identifier
1962938167
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7485 Issued in CO
Legal business name
MONTROSE DENTAL PLLC
Practice address
629 E Star CT
Montrose, CO 81401-6701
Phone
(970) 249-3330
Fax
(970) 249-4171
NPI assigned
May 8, 2017
Last updated
May 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Authorized official

Name
Ms. Lyn M Hyatt
Title
Office Manager
Phone
(970) 249-3330

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 7485 CO Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6675 CO
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 202414 CO

Addresses

Primary practice location

629 E Star CT
Montrose, CO 81401-6701

Mailing address

629 E Star CT
Montrose, CO 81401-6701
Phone (970) 249-3330

Other identifiers 1

IdentifierTypeStateIssuer
04430344MedicaidCO

Other names 1

  • Hansen, Amundson and Horkan Dental Group Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1494201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1962938167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 E STAR CT",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016701",
            "telephone_number": "970-249-3330",
            "fax_number": "970-249-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 E STAR CT",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016701",
            "telephone_number": "970-249-3330",
            "fax_number": "970-249-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTROSE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-08",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "HYATT",
        "authorized_official_first_name": "LYN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-249-3330",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7485",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6675",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "202414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04430344",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hansen, Amundson and Horkan Dental Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 8, 2017; 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.