Edgar P Poremba DDS MSD PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

105719 Issued in CO

Legal business name

EDGAR P POREMBA DDS MSD PC

Practice address

2997 Broadmoor Valley Rd
Colorado SPGS, CO 80906-4405

Phone

(719) 576-0149

Fax

(719) 579-5373

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edgar P Poremba, DDS MSDNPI 1659594232

Title

Orthodontist

Phone

(719) 576-0149

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Edgar Paul Poremba, DDS MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Colorado SPGS, CO
  • NPI 1659594232
  Authorized official Same address or phone

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982758173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2997 BROADMOOR VALLEY RD",
            "city": "COLORADO SPGS",
            "state": "CO",
            "postal_code": "809064405",
            "telephone_number": "719-576-0149",
            "fax_number": "719-579-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2997 BROADMOOR VALLEY RD",
            "city": "COLORADO SPGS",
            "state": "CO",
            "postal_code": "809064405",
            "telephone_number": "719-576-0149",
            "fax_number": "719-579-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR P POREMBA DDS MSD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POREMBA",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "719-576-0149",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "105719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Delametter, OTD, OTR/L
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• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado SPGS, CO
• Providers in Colorado SPGS, CO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.