PRESTIGE DENTURE CLINIC (NPI# 1588079651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588079651 |
| Entity Type | Organization |
| Organization Name | PRESTIGE DENTURE CLINIC |
| Practice Address |
1700 N Salem Ave Suite B Pueblo CO 81001-2846 |
| Practice Telephone | 7192990777 |
| Practice Fax Number | 7195821099 |
| Mailing Telephone | 7192990777 |
| Mailing Fax Number | 7195821099 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |
| Authorized Official Name | DANIEL ROYBAL (OWNER) |
| Authorized Official Telephone | 7192990777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 292200000X | Dental Laboratory | Laboratories |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PRESTIGE DENTURE CLINIC CORP | 5500 Ne 109th Ct, Suite B, Vancouver, WA 98662-6104 |
| Street Address |
1700 N SALEM AVE SUITE B |
| City | PUEBLO |
| State | CO |
| Zip Code | 81001-2846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518171008 | George Henry Beck | Dentist | 1700 N Salem Ave, Suite A, Pueblo, CO 81001 | 2007-05-10 |
| 1912446592 | Joshua Machone | Dentist | 1700 N Salem Ave, Pueblo, CO 81001 | 2017-02-16 |
| 1699100982 | Pueblo Dental Center of Pueblo | Dentist | 1700 N Salem Ave, Suite B, Pueblo, CO 81001-2846 | 2013-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588222863 | 1111 Bonforte Opco LLC | Respite Care | 855 Hunter Dr., Pueblo, CO 81001 | 2019-06-03 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1609146950 | Natasha Liette Mondragon | Registered Nurse | 1302 E. 5th, Pueblo, CO 81001 | 2012-01-04 |
| 1023303575 | Malinda Lee Davis | Registered Nurse | 1302 E 5th, Pueblo, CO 81001 | 2011-06-13 |
| 1679876429 | Michael Edward Leyba | Substance Abuse Rehabilitation Facility | 4 Montebello Rd., Pueblo, CO 81001 | 2010-12-17 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1730380882 | Corrine Stella Tafoya | Counselor | 44 Calhoun Rd, Pueblo, CO 81001 | 2007-05-29 |
| 1609096999 | Pueblo Endodontic Asso LLC | Dentist | 41 Montebello, Suite 206, Pueblo, CO 81001 | 2007-04-27 |
| Find all providers in zip 81001 | ||||
| Taxonomy Code | 292200000X |
| Grouping | Laboratories |
| Classification | Dental Laboratory |
| A commercial laboratory specializing in the construction of dental appliances that conform to a dentist’s specifications including the construction of dentures (complete or partial), orthodontic appliances, bridgework, crowns, and inlays. |
| Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 1245. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619244167 | Saunders Implant & Denture Care | Dental Laboratory | 902 W 29th St, Pueblo, CO 81008-1159 | 2011-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992318455 | Bio-aesthetics Dental Studio Inc | Dental Laboratory | 1001 N 3rd St, Grand Junction, CO 81501-7580 | 2020-08-25 |
| 1609499839 | John R Witt | Dental Laboratory | 17586 E Dickenson Pl, Aurora, CO 80013-4180 | 2020-05-21 |
| 1356852214 | Bioemulation Lab and Imaging Inc | Dental Laboratory | 1475 Pine Grove Rd, Steamboat Springs, CO 80487-8803 | 2017-10-18 |
| 1548444680 | Robert O Greer Jr Dds Scd | Dental Laboratory | 180 Adams St, 250, Denver, CO 80206-5223 | 2007-12-26 |
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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.