Individual provider Active NPI

Edward Bertagnolli, DDS

  • Dentist
  • Westminster, CO
National Provider Identifier
1982008819
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
HDL00161 Issued in CO
Practice address
7280 Bradburn Blvd
Westminster, CO 80030-5224
Phone
(303) 429-6222
Fax
(303) 429-7247
NPI assigned
Oct 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X HDL00161 CO Primary

Addresses

Primary practice location

7280 Bradburn Blvd
Westminster, CO 80030-5224

Mailing address

7280 Bradburn Blvd
Westminster, CO 80030-5224
Phone (303) 429-6222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HDL00161COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward J. Bertagnolli, DDS, PC Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1982008819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7280 BRADBURN BLVD",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800305224",
            "telephone_number": "303-429-6222",
            "fax_number": "303-429-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7280 BRADBURN BLVD",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800305224",
            "telephone_number": "303-429-6222",
            "fax_number": "303-429-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTAGNOLLI",
        "first_name": "EDWARD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "HDL00161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.