Pueblo Dental Services LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PUEBLO DENTAL SERVICES LLC

Doing business as

Pueblo Dental and Implant Services

Practice address

200 W 29TH St # B
Pueblo, CO 81008-1004

Phone

(719) 542-9374

Fax

(719) 542-9433

NPI assigned

Oct 24, 2023

Last updated

Oct 24, 2023By 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

Dr. Mehron Kazemi, DDSNPI 1699150219

Title

Owner

Phone

(303) 669-8908

Specialties & licenses 1

Addresses

Other names 1

• Pueblo Dental and Implant Services Doing business as

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.

• Mehron Kazemi, DDS

  • Dentist
  • Denver, CO
  • NPI 1699150219
  NPD Authorized official
• Rachel Veronica Baird, RDH

  • Dental Hygienist
  • Pueblo, CO
  • NPI 1164311577
  NPD (past)

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1992577860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 BOGUS PL",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213872",
            "telephone_number": "303-669-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 29TH ST # B",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081004",
            "telephone_number": "719-542-9374",
            "fax_number": "719-542-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO DENTAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "KAZEMI",
        "authorized_official_first_name": "MEHRON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-669-8908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pueblo Dental and Implant Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pueblo Community Resources Co. Inc.
• Pueblo County (Dept of Social Services)
• Pueblo County School Dist 70
• Pueblo Dental & Braces
• Pueblo Dental Center of Pueblo
• Pueblo Department of Public Health and Environment
• Pueblo Diversified Industries, Inc.
• Pueblo Ear Nose & Throat Specialist
• Pueblo Endodontic Asso LLC
• Pueblo Endoscopy Suites, LLC

• General Practice Dentistry in Pueblo, CO
• Providers in Pueblo, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.