PUEBLO FAMILY DENTISTRY PLLC (NPI# 1497382303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497382303 |
| Entity Type | Organization |
| Organization Name | PUEBLO FAMILY DENTISTRY PLLC |
| Practice Address |
701 N Grand Avenue Suite B Pueblo CO 81003 |
| Mailing Address |
2810 S. Academy Blvd. Suite# 130 Colorado Springs CO 80916 |
| Practice Telephone | 7192104097 |
| Mailing Telephone | 7194182456 |
| Mailing Fax Number | 7192478925 |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-03-23 |
| Authorized Official Name | DR. SOMI M LIM (DENTIST/OWNER) |
| Authorized Official Telephone | 7194182456 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Pueblo Family Dentistry PLLC | 5960 Wilson Road, Colorado Springs, CO 80919 |
| Street Address |
701 N GRAND AVENUE SUITE B |
| City | PUEBLO |
| State | CO |
| Zip Code | 81003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042016 | Sunil Kumar | Student in an Organized Health Care Education/Training Program | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2020-04-21 |
| 1023654241 | Elmer A. Villalon, Dmd, LLC | Clinic/Center | 1225 North Main Street, #207, Pueblo, CO 81003 | 2019-11-22 |
| 1518434349 | Mariam Rahim | Internal Medicine | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-10-30 |
| 1003308222 | Julia Mcneice | Internal Medicine | Parkview Medial Center, Parkveiw Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-06-04 |
| 1689164857 | Jessica Sels | Internal Medicine | Parkview Medical Center Adult Medicine Clinic, 311 W 14th St, Pueblo, CO 81003 | 2018-05-14 |
| 1700313459 | Allison Vigil | Occupational Therapist | 1600 W. 24th St, Pueblo, CO 81003 | 2017-05-12 |
| 1245682020 | Paul S Bongat | Internal Medicine | 411 W. 14th St., Parkview Adult Medicine Clinic, Pueblo, CO 81003 | 2016-07-06 |
| 1013368596 | Daniel R Long | Internal Medicine | 411 West 14th Street, Pueblo, CO 81003 | 2016-06-27 |
| 1396195665 | Parkview Medical Center | General Acute Care Hospital | 411 W. 14th St, Pueblo, CO 81003 | 2016-06-17 |
| 1598114381 | Parkview Medical Center | Chronic Disease Hospital | 411 West 14th St, Pueblo, CO 81003 | 2016-06-13 |
| Find all providers in zip 81003 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326673880 | Charles Wohlwend Ddspc | Dentist | 1044 Eagleridge Blvd, Pueblo, CO 81008-2130 | 2020-03-05 |
| 1245758168 | Jenny C Alas | Dentist | 2603 Vinewood Lane, Pueblo, CO 81005 | 2017-08-30 |
| 1891222402 | Pueblo Dental & Braces | Dentist | 1345 S Pueblo Blvd, Pueblo, CO 81005-1508 | 2017-05-12 |
| 1346798923 | Dr Tina L Skinner Dds Ms PC | Dentist | 2047 Columbia Dr, Pueblo, CO 81005-3279 | 2016-09-13 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1346608197 | Michael E Allen | Dentist | 1800 Fortino Blvd Unit 2, Pueblo, CO 81008-1891 | 2016-02-08 |
| 1851777304 | James Kellan Villalon | Dentist | 1225 N Main St Ste 207, Pueblo, CO 81003-2857 | 2015-08-07 |
| 1689080848 | Gregory Ragulsky | Dentist | 3939 Sandalwood Ln, Pueblo, CO 81005-2586 | 2014-07-09 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1205276128 | Advantage Dental Group | Dentist | 1800 Fortino Blvd Unit 1, Pueblo, CO 81008-1891 | 2013-06-25 |
| Find all providers in PUEBLO | ||||
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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.