NPIMap

Organization Active NPI

Thornton Valley Dental

  • Dental Clinic/Center
  • Thornton, CO
National Provider Identifier
1972033280
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
00202110 Issued in CO
Legal business name
THORNTON VALLEY DENTAL
Practice address
16683 Washington St BLDG 5
Thornton, CO 80023-8970
Phone
(303) 450-3165
NPI assigned
Jun 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Evan Tyler CettieNPI 1881024420
Title
Owner
Phone
(832) 470-6344

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 00202110 CO Primary

Addresses

Primary practice location

16683 Washington St BLDG 5
Thornton, CO 80023-8970

Mailing address

16683 Washington St BLDG 5
Thornton, CO 80023-8970
Phone (303) 450-3165

National Provider Directory

National Provider Directory

Locations

16683 Washington St
Bldg 5
Thornton, CO 80023
Phone (303) 450-3165

Practitioners & affiliated clinicians

Practitioners 2

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": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972033280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16683 WASHINGTON ST BLDG 5",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "800238970",
            "telephone_number": "303-450-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16683 WASHINGTON ST BLDG 5",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "800238970",
            "telephone_number": "303-450-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORNTON VALLEY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CETTIE",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-470-6344"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "00202110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.