HUNTERS GLEN DENTAL PROFESSIONALS , NPI 1063730497 — COMFORT DENTAL HUNTERS GLEN in THORNTON (CO)

NPI 1063730497

9+ Years Experience Organization

HUNTERS GLEN DENTAL PROFESSIONALS

Other organization name: COMFORT DENTAL HUNTERS GLEN. Name type code: 3 - doing business as (d/b/ a) name.

05.10.2010
PROVIDER ENUMERATION DATE
05.10.2010
LAST UPDATE DATE
1063730497
NPI NUMBER

About HUNTERS GLEN DENTAL PROFESSIONALS

HUNTERS GLEN DENTAL PROFESSIONALS is a provider established in THORNTON, CO. The NPI number of HUNTERS GLEN DENTAL PROFESSIONALS is 1063730497 and was assigned on 05.10.2010. The practitioners primary taxonomy code is: 1223G0001X with license number: 9066 CO .

Mailing address

  • City: THORNTON
  • State: CO
  • Postal code: 806027051
  • Phone: 3039202273
  • Fax: 3032804533
  • Address: 13691 COLORADO BLVD
  • Address 2: SUITE 109

Primary Practice Address

  • Region : THORNTON, CO
  • NPI : 1063730497
  • Phone : 3039202273
  • Fax : 3032804533
  • Postalcode : 806027051
  • Address : 13691 COLORADO BLVD SUITE 109

Provider taxonomy - Dentist

  • Taxonomy code: 1223G0001X
  • License number: 9066
  • License state: CO

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193400000X SINGLE SPECIALTY GROUP.

Taxonomy description: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients" oral health needs.

Contacts:

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  • HUNTERS GLEN DENTAL PROFESSIONALS
  • Address : 13691 COLORADO BLVD SUITE 109
  • Region : THORNTON, CO
  • NPI : 1063730497
  • Phone : 3039202273
  • Fax : 3032804533
  • Postalcode : 806027051

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3039202273
  • Title or position : DENTIST/OWNER

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address13691 COLORADO BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 109
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameTHORNTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCO
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code806027051
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3039202273
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3032804533
The fax number associated with the location address of the provider being identified.
NPI1063730497
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 11223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients" oral health needs.
Provider Enumeration Date05.10.2010
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated05.10.2010
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)HUNTERS GLEN DENTAL PROFESSIONALS
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameCOMFORT DENTAL HUNTERS GLEN
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address13691 COLORADO BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 109
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameTHORNTON
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCO
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code806027051
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3039202273
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3032804533
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameSOUSA
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameAPRIL
The first name of the authorized official
Authorized Official Title or PositionDENTIST/OWNER
The title or position of the authorized official
Authorized Official Telephone Number3039202273
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #11223G0001X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients" oral health needs.
Provider License Number 19066
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1CO
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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