NPIMap

Organization Active NPI

Lincoln Ave Dentistry

  • Dentist
  • Parker, CO
National Provider Identifier
1992195507
Registry record updated Feb 3, 2015
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN 10365 Issued in CO
Legal business name
LINCOLN AVE DENTISTRY
Practice address
16522 Keystone Blvd
Unit T
Parker, CO 80134-3303
Phone
(720) 638-2075
Fax
(303) 284-2540
NPI assigned
Feb 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Dr. Stanley Samuel, DDS
Title
President
Phone
(720) 638-2075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DEN 10365 CO Primary

Addresses

Primary practice location

16522 Keystone Blvd
Unit T
Parker, CO 80134-3303

Mailing address

16522 Keystone Blvd
Unit T
Parker, CO 80134-3303
Phone (720) 638-2075

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1992195507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16522 KEYSTONE BLVD",
            "address_2": "UNIT T",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801343303",
            "telephone_number": "720-638-2075",
            "fax_number": "303-284-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16522 KEYSTONE BLVD",
            "address_2": "UNIT T",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801343303",
            "telephone_number": "720-638-2075",
            "fax_number": "303-284-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN AVE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "720-638-2075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN 10365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.