Ccdi Parker PDC PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CCDI PARKER PDC PLLC

Practice address

10841 Crossroads Dr Ste 9
Parker, CO 80134-9090

Phone

(303) 333-1844

NPI assigned

May 30, 2019

Organization subpart

No

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

Authorized official

Name

Jacob Warner

Title

Credentialing Manager

Phone

(801) 691-1701

Specialties & licenses 4

Addresses

Other names 1

• Cherry Creek Dental Implant Doing business as

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1992363444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970057",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840970309",
            "telephone_number": "801-305-3460",
            "fax_number": "801-335-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10841 CROSSROADS DR STE 9",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801349090",
            "telephone_number": "303-333-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCDI PARKER PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "801-691-1701"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherry Creek Dental Implant",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Barron Cava, M.D.
• Laura Cavalcanti
• Whitney Cavanah, MA, LPCC
• Kaitlyn Anne Cavanaugh, MS, OTR/L, CLC
• William Cavell
• Elizabeth Ann Briscoe Cedrone, PA-C
• Cassandra J Celentano
• Center at Lincoln, LLC
• Central Colorado Anesthesia Associates, LLC
• Centura Ventures, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.