CHEYENNE MOUNTAIN MODERN DENTISTRY, LLP (NPI# 1336512540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336512540 |
| Entity Type | Organization |
| Organization Name | CHEYENNE MOUNTAIN MODERN DENTISTRY, LLP |
| Other Organization Name | CHEYENNE MOUNTAIN MODERN DENTISTRY AND ORTHODONTICS |
| Practice Address |
4451 Venetucci Blvd Suite 160 Fountain CO 80906 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 7198000399 |
| Practice Fax Number | 7193594158 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |
| Authorized Official Name | DR. RYAN M PFEIFER (OWNER) |
| Authorized Official Telephone | 7198000399 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Cheyenne Mountain Modern Dentistry and Orthodontics | Doing Business As Name - Organization |
| Street Address |
4451 VENETUCCI BLVD SUITE 160 |
| City | FOUNTAIN |
| State | CO |
| Zip Code | 80906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437797339 | Michael Crise | Behavior Technician | 1330 Qual Lake Loop Ste 120, Colorado Springs, CO 80906 | 2019-12-11 |
| 1730720541 | Amanda Salinas | Massage Therapist | 1235 Lake Plaza Drive Suite 230, Colorado Springs, CO 80906 | 2019-10-02 |
| 1225511488 | Sheila Meggison | Massage Therapist | 1235 Lake Plaza Drive, Suite 230, Colorado Springs, CA 80906 | 2018-09-12 |
| 1316429756 | Vivus Counseling Services LLC | Counselor | 108 East Cheyenne Rd Suite 201, Colorado Springs, CO 80906 | 2018-09-01 |
| 1043796949 | Erin Lee Recinos | Nurse Practitioner | 225 E Cheyenne Mountain Blvd Ste 220, Colorado Springs, CO 80906 | 2018-07-13 |
| 1982103875 | Savannah Adeline Rentrop | Behavior Technician | 2989 Broadmoor Valley Rd D, Colorado Springs, CO 80906 | 2018-02-06 |
| 1205335288 | Ross Knowlton | Behavior Technician | 1330 Quail Lake Loop Suite 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1942709845 | Adrienne Bohlen | Behavior Technician | 1330 Quail Lake Loop, Ste. 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1881110088 | Christine Gonzales | Nurse Practitioner | 2739 E Las Vegas St, Colorado Springs, CO 80906 | 2017-08-18 |
| 1225568470 | Larry Alwine | Counselor | 2860 South Circle Drive, Unit 250k, Colorado Springs, CO 80906 | 2017-06-19 |
| Find all providers in zip 80906 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801234489 | Janica Joli Gillette-backstrom | Dentist | 6940 Mesa Ridge Parkway, Fountain, CO 80817 | 2013-06-05 |
| 1972828630 | Nathan Hal Barton | Dentist | 8085 Fountain Mesa Rd, Fountain, CO 80817-1591 | 2010-04-06 |
| 1205028941 | Just for Grins LLC | Dentist | 6436 S Us Highway 85-87, Suite C, Fountain, CO 80817 | 2007-08-16 |
| 1760552491 | Fountain Dental Center, PC | Dentist | 320 S Santa Fe Ave, Fountain, CO 80817-1963 | 2006-11-09 |
| 1720171564 | Colorado Dental Professionals, LLC | Dentist | 6980 Mesa Ridge Parkway, Suite 200, Fountain, CO 80817 | 2006-10-02 |
| 1326013673 | Jeff O Johnson | Dentist | 200 Plaza Blvd, Fountain, CO 80817-2504 | 2006-02-21 |
| 1437120151 | George Ranta | Dentist | 6980 Mesa Ridge Pkwy, Suite 200, Fountain, CO 80817-1533 | 2006-01-30 |
| 1811541402 | My Local Colorado Dental Practice, LLC | Dentist | 8085 Fountain Mesa Rd, Fountain, CO 80817-1591 | 2019-07-31 |
| 1467661967 | Johnson and Associates Dds PC | Dentist | 200 Plaza Blvd, Fountain, CO 80817-2504 | 2007-05-21 |
| 1033246368 | George V. Ranta, D.d. S., A Professional Corporation | Dentist | 6980 Mesa Ridge Pkwy, Suite 200, Fountain, CO 80817-1563 | 2007-02-27 |
| Find all providers in FOUNTAIN | ||||
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| 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.