PEDIATRIC DENTAL GROUP OF WHEAT RIDGE


Address: 3555 Lutheran Pkwy, Suite 310, Wheat Ridge, CO 80033-6021
Phone: 3034678888

PEDIATRIC DENTAL GROUP OF WHEAT RIDGE (NPI# 1043747900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043747900
Entity Type Organization
Organization Name PEDIATRIC DENTAL GROUP OF WHEAT RIDGE
Practice Address 3555 Lutheran Pkwy
Suite 310
Wheat Ridge
CO 80033-6021
Practice Telephone 3034678888
Enumeration Date 2017-05-22
Last Update Date 2017-05-22
Authorized Official Name KRISTEN BARDEN (PRACTICE MANAGER)
Authorized Official Telephone 3034215437
Is Organization Subpart Y
Parent Organization Name PEDIATRIC DENTAL GROUP OF COLORADO

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 1223P0221X Dentist
Specialization: Pediatric Dentistry
8332 CO Dental Providers
N 1223P0221X Dentist
Specialization: Pediatric Dentistry
651 CO Dental Providers
N 1223P0221X Dentist
Specialization: Pediatric Dentistry
10389 CO Dental Providers
N 1223X0400X Dentist
Specialization: Orthodontics and Dentofacial Orthopedics
104994 CO Dental Providers
N 1223X0400X Dentist
Specialization: Orthodontics and Dentofacial Orthopedics
104928 CO Dental Providers
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
7843 CO Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
CO 64351084 05
CO 02078434 05
CO 56483546 05
CO 02006518 05
CO 81227078 05
CO 38371847 05

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Pediatric Dental Group of Wheat Ridge, PC Medical Office Building Iv, 3555 Lutheran Parkway, Suite 310, Wheat Ridge, CO 80033

Office Location

Street Address 3555 LUTHERAN PKWY
SUITE 310
City WHEAT RIDGE
State CO
Zip Code 80033-6021

Providers in the same location

NPI Name Taxonomy Address Enumeration
1831194463 Caroline Teresa Thramann Pediatrics 3555 Lutheran Pkwy, Ste 340, Wheat Ridge, CO 80033-6039 2005-06-20
1043663248 Brielle Smith Physician Assistant 3555 Lutheran Pkwy, Suite 340, Wheat Ridge, CO 80033-6021 2016-07-22
1295015261 Rose Shehan Registered Nurse 3555 Lutheran Pkwy, 180, Wheat Ridge, CO 80033-6021 2011-08-23
1932499761 Yamini Bear Rao Pediatrics 3555 Lutheran Pkwy, #340, Wheat Ridge, CO 80033-6021 2011-04-13
1497062467 Barbara Calo Nurse Practitioner 3555 Lutheran Pkwy, Suite 200, Wheat Ridge, CO 80033-6021 2010-09-10
1184940884 Michael A. Tralla M.d., P.C. Specialist 3555 Lutheran Pkwy, Ste 160, Wheat Ridge, CO 80033-6017 2010-04-20
1104148097 Pamela Fae Penrose Physician Assistant 3555 Lutheran Pkwy, Ste 340, Wheat Ridge, CO 80033-6021 2010-02-19
1063744357 Melanie Ruth Sida Nurse Practitioner 3555 Lutheran Pkwy, Wheat Ridge, CO 80033-6021 2010-02-11
1144552571 Jaimes Ellen Vail Physician Assistant 3555 Lutheran Pkwy, Suite 340, Wheat Ridge, CO 80033-6021 2010-02-10
1922330406 Cynthia Lynne Nugent Nurse Practitioner 3555 Lutheran Pkwy, 340, Wheat Ridge, CO 80033-6021 2010-02-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154893915 Bronwyn Hockersmith Counselor 3954 Yosemite St, Wheat Ridge, CO 80033 2018-12-18
1902392004 Thousand Peaks Healthcare, Inc. In Home Supportive Care 4891 Independence St Ste 285, Wheat Ridge, CO 80033 2018-07-02
1528586120 Front Range Family Resource Center Marriage & Family Therapist 5181 Ward St Ste 201, Wheat Ridge, CO 80033 2017-09-03
1962920918 Dianna Lee Cordero Counselor 4931 Garrison St., Apt 104, Wheat Ridge, CO 80033 2017-08-30
1396261525 Lauren Faye Petasne Nurse Practitioner 7100 W 44th Ave Ste 101a, Wheat Ridge, CO 80033 2017-08-18
1558802421 Elizabeth Ann Huddleston Nurse Practitioner 3400 N Lutheran Pkwy, Wheat Ridge, CO 80033 2017-03-13
1053777045 Richard Kerry Brandow Counselor 16625 W 50th Ave., Golden, CO 80033 2016-01-07
1831562131 Eternal Life Care Centers, LLC Assisted Living Facility 4370 Ingalls Street, Wheat Ridge, CO 80033 2015-11-09
1740663483 Real Care, Inc. Private Vehicle 10200 West 44th Ave, Suite 200, Wheat Ridge, CO 80033 2015-06-30
1508254848 Pamela June Weitzel Midwife 3555 Lutheran Parkway Suite 210, Wheat Ridge, CO 80033 2015-01-08
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Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164815841 D. Malcolm Strange Dds, Msd, P.C. Dentist 8550 W 38th Ave, Suite 306, Wheat Ridge, CO 80033-4300 2015-03-05
1578798955 Ashley Noel Underwood Dentist 8550 W 38th Ave, Suite 306, Wheat Ridge, CO 80033-4300 2009-05-28
1164473625 David Malcolm Strange Dentist 8550 W 38th Ave, #306, Wheat Ridge, CO 80033-4300 2006-05-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578181103 Stettler Kr Broadmoor Pllc Dentist 4515 Broadmoor Bluffs Dr, Colorado Springs, CO 80906-8647 2020-07-09
1043842453 Highlands Pediatric Dentistry Dentist 3141 Irving St Unit 200, Denver, CO 80211-3654 2020-02-04
1174163711 J Patrick Bowman Dmd Pllc Dentist 1280 S Pearl St, Denver, CO 80210-1538 2020-01-12
1487211124 Rebecca Goldberg, Dds, Pllc Dentist 2975 Roslyn St Unit 160, Denver, CO 80238-3326 2019-05-28
1427521509 Kids Mile High Thornton Pllc Dentist 7375 E. 128th Ave, Thornton, CO 80602 2019-01-10
1578060299 Julia Rose Wiegand Dentist 2352 Meadows Blvd Ste 200, Castle Rock, CO 80109-8408 2018-04-09
1215432141 Dan Duy Hoang Dentist 660 Southpointe Ct Ste 100, Colorado Springs, CO 80906-3806 2018-03-23
1053851485 Allison Threlkeld Davis Dentist 404 E Mineral Ave Ste A, Littleton, CO 80122-2611 2017-03-04
1649624362 Curley Peak Dentistry Pllc Dentist 1640 W Fortino Blvd, Pueblo, CO 81008 2016-04-19
1942673512 A. P. Smithwick D.d.s. IIi Professional LLC Dentist 125 Inverness Dr E Ste 300, Englewood, CO 80112-5139 2015-11-04
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Competitor

Search similar providers

City WHEAT RIDGE
Zip Code 80033

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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