NPIMap

Organization Active NPI

Dental Aid, Inc

  • General Practice Dentistry
  • Boulder, CO
National Provider Identifier
1972109957
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL AID, INC
Practice address
4155 Darley Ave Ste C
Boulder, CO 80305-6536
Phone
(303) 499-7072
Fax
(303) 200-7375
NPI assigned
Dec 7, 2020
Organization subpart
Yes
Parent organization
DENTAL AID, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Jubie Tafoya-Quezada
Title
Senior Office Administrator
Phone
(303) 655-8228

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X

Addresses

Primary practice location

4155 Darley Ave Ste C
Boulder, CO 80305-6536

Mailing address

877 E South Boulder Rd
Louisville, CO 80027-1345
Phone (303) 655-8228

Other identifiers 1

IdentifierTypeStateIssuer
04004172MedicaidCO

Other names 1

  • Dental Aid, Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Aid Inc4 organizations share this tax ID, including this one
Part of
Dental Aid Inc

Other organizations with this tax ID 3

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

Locations

4155 Darley Ave
Ste C
Boulder, CO 80305
Phone (303) 499-7072

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

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": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1972109957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 E SOUTH BOULDER RD",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271345",
            "telephone_number": "303-655-8228",
            "fax_number": "303-200-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 DARLEY AVE STE C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056536",
            "telephone_number": "303-499-7072",
            "fax_number": "303-200-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL AID, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL AID, INC",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "TAFOYA-QUEZADA",
        "authorized_official_first_name": "JUBIE",
        "authorized_official_title_or_position": "SENIOR OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "303-655-8228"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04004172",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Aid, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.