Fruita Canyon Dental

Primary specialty

DentistTaxonomy code 122300000X

License

8989 Issued in CO

Legal business name

FRUITA CANYON DENTAL

Practice address

288 W Pabor Ave
Fruita, CO 81521-2153

Phone

(970) 858-8484

Fax

(970) 858-8484

NPI assigned

Jun 30, 2016

Last updated

Jun 30, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Krehl William Stegelmeier, D.D.S.NPI 1447355490

Title

Dentist

Phone

(970) 858-8484

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Krehl William Stegelmeier, DDS

  • General Practice Dentistry
  • Fruita, CO
  • NPI 1447355490
  NPD (past) Authorized official
• Kelsey Veneman Bumgarner, DMD

  • General Practice Dentistry
  • Fruita, CO
  • NPI 1316432347
  NPD (past)

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1972954949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 W PABOR AVE",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815212153",
            "telephone_number": "970-858-8484",
            "fax_number": "970-858-6436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 W PABOR AVE",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815212153",
            "telephone_number": "970-858-8484",
            "fax_number": "970-858-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRUITA CANYON DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "STEGELMEIER",
        "authorized_official_first_name": "KREHL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "970-858-8484",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "8989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16183274",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Extra Mile Service
• Laken Renee Eyler, PA-C
• Charles Robert Fowler, MD
• Sarah Franzitta
• Eric W Frevert, PA
• Fruita Chiropractic and Massage
• Angela Kuzminski Gao, DO
• Gary Andreoletti DDS PC
• Joshua Gavin, DO
• Susan Jean Gemmell-Crosby, OTR

• Dentist in Fruita, CO
• Providers in Fruita, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.