CHEYENNE MOUNTAIN CHILDREN'S DENTISTRY PC (NPI# 1578725743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578725743 |
| Entity Type | Organization |
| Organization Name | CHEYENNE MOUNTAIN CHILDREN'S DENTISTRY PC |
| Practice Address |
6514 S Academy Blvd Colorado Springs CO 80906-8614 |
| Mailing Address |
6514 S Academy Blvd Colorado Springs CO 80906 |
| Practice Telephone | 7194421960 |
| Mailing Telephone | 7194421960 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |
| Authorized Official Name | MICHAEL J. PURCELL (OWNER/DENTIST) |
| Authorized Official Telephone | 7194421960 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
7055 | CO | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | UNITED CONCORIDA | 000789815 | 01 |
| CO | 0207555 | 05 |
| Street Address |
6514 S ACADEMY BLVD |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80906-8614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578117198 | Colorado Dental Specialist Practice, LLC | Dentist | 6514 S Academy Blvd, Colorado Springs, CO 80906-8614 | 2019-07-31 |
| 1457905119 | My Local Colorado Dental Practice, LLC | Dentist | 6514 S Academy Blvd, Colorado Springs, CO 80906-8614 | 2019-07-30 |
| 1003345174 | Kassie Lynette Jane Taylor | Dental Hygienist | 6514 S Academy Blvd, Colorado Springs, CO 80906-8614 | 2017-06-12 |
| 1790211969 | Leslie Lee | Dental Hygienist | 6514 S Academy Blvd, Colorado Springs, CO 80906-8614 | 2017-05-10 |
| 1659702769 | South Springs Dental Professional LLC | Dentist | 6514 S Academy Blvd, Colorado Springs, CO 80906-8614 | 2013-11-29 |
| 1639310873 | Britny Massey Dds,pc | Dentist | 6514 S Academy Blvd, Colorado Springs, CO 80906-8614 | 2009-03-18 |
| 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 | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578181103 | Stettler Kr Broadmoor Pllc | Dentist | 4515 Broadmoor Bluffs Dr, Colorado Springs, CO 80906-8647 | 2020-07-09 |
| 1215432141 | Dan Duy Hoang | Dentist | 660 Southpointe Ct Ste 100, Colorado Springs, CO 80906-3806 | 2018-03-23 |
| 1275844607 | Corban R. Stettler | Dentist | 5430 E Woodmen Rd, Colorado Springs, CO 80920-8067 | 2010-06-30 |
| 1346467206 | Joshua Erickson | Dentist | 8580 Scarborough Dr Ste 220, Colorado Springs, CO 80920-7583 | 2007-04-19 |
| 1154488575 | Jeffrey Allen Kahl | Dentist | 9480 Briar Village Pointe Suite 320, Colorado Springs, CO 80920 | 2007-01-03 |
| 1063598720 | Michelle Lee Haman | Dentist | 6725 Rangewood Dr, Colorado Springs, CO 80918-7300 | 2006-10-27 |
| 1245331552 | Clinton T. Callahan | Dentist | 13335 Voyager Pkwy Ste 100, Colorado Springs, CO 80921 | 2006-09-26 |
| 1427154418 | Michael J Purcell | Dentist | 12225 Voyager Pkwy Ste 6, Colorado Springs, CO 80921-3754 | 2006-09-16 |
| 1669464632 | Edward A Souza | Dentist | 3466 Briargate Blvd, Colorado Springs, CO 80920-4168 | 2005-08-16 |
| 1386642627 | Robert Dean Thoman | Dentist | 1304 N Academy Blvd, Colorado Springs, CO 80909-3325 | 2005-07-11 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80906 |
Please comment or provide details below to improve the information on CHEYENNE MOUNTAIN CHILDREN'S DENTISTRY PC.
| 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.