SAN JUAN DENTAL ANESTHESIA SERVICES, PROFESSIONAL LLC (NPI# 1609250810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609250810 |
| Entity Type | Organization |
| Organization Name | SAN JUAN DENTAL ANESTHESIA SERVICES, PROFESSIONAL LLC |
| Practice Address |
835 E 2nd Ave Suite 270 Durango CO 81301-5475 |
| Practice Telephone | 9702474848 |
| Practice Fax Number | 8778887642 |
| Mailing Telephone | 9702474848 |
| Mailing Fax Number | 8778887642 |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |
| Authorized Official Name | DR. TAYLOR CLARK (OWNER) |
| Authorized Official Telephone | 9702474848 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
201890 | CO | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | San Juan Dental Anesthesia Services, Professional LLC | 835 E. 2nd Avenue, Suite 270, Durango, CO 81301 |
| Street Address |
835 E 2ND AVE SUITE 270 |
| City | DURANGO |
| State | CO |
| Zip Code | 81301-5475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003841586 | Mark F Ugai | Dentist | 835 E 2nd Ave, Suite 270, Durango, CO 81301-5475 | 2006-07-12 |
| 1225433170 | Taylor M. Clark, D.d.s., Professional LLC | Clinic/Center | 835 E 2nd Ave, Suite 270, Durango, CO 81301-5475 | 2014-11-04 |
| 1366681637 | Southwest Center for Independence | Home Health | 835 E 2nd Ave, Suite 200, Durango, CO 81301-5475 | 2009-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003541 | High Country Counseling, LLC | Social Worker | 101 East 31st Street, Unit B, Durango, CO 81301 | 2019-09-20 |
| 1033629431 | Southern Rockies Addiction Treatment Services | Substance Abuse Rehabilitation Facility | 736 Goeglein Gulch, Durango, CO 81301 | 2017-10-11 |
| 1649710583 | Dr. Michael Washinsky, LLC | Psychiatry & Neurology | 1800 East 3rd Ave., Suite 102, Durango, CO 81301 | 2017-02-25 |
| 1578000113 | Taylor Ferraro | Prevention Professional | 221 E 4th Ave Unit B, Durango, CO 81301 | 2017-01-20 |
| 1467811224 | Newelldixon, Pllc | Clinic/Center | 29423 E. Highway 160, Durango, CO 81301 | 2016-02-22 |
| 1699146803 | Leah Linder | Naturopath | 117 Cr 250. Suite A, Durango, CO 81301 | 2015-10-14 |
| 1780065136 | Jeffrey Hines | Occupational Therapy Assistant | 970 Silver Mesa Driveway, Durango, CO 81301 | 2015-06-11 |
| 1467832410 | Sara Supinski LLC | Clinic/Center | 1911 Main Ave, Suite 240, Durango, CO 81301 | 2015-06-04 |
| 1356735146 | Margaret Austin | Massage Therapist | 1309 E 3rd Avenue, Durango, CO 81301 | 2015-03-19 |
| 1891112280 | Lisa Ann Proulx | Health Educator | 3 Springs Blvd.. Suite 201, Durango, CO 81301 | 2014-03-24 |
| Find all providers in zip 81301 | ||||
| Taxonomy Code | 1223D0004X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dentist Anesthesiologist |
| A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. |
| Notes: Source: The American Society of Dentist Anesthesiologists [1/1/2013: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457843799 | Kristopher Mendoza | Dentist | 811 Brickyard Cir # A, Golden, CO 80403-8058 | 2018-06-02 |
| 1093222788 | Sleepcare Dental LLC | Dentist | 5005 S Kipling Pkwy Ste A7-394, Littleton, CO 80127-7930 | 2018-01-04 |
| 1649785197 | 5280 Dentistry and Anesthesia | Dentist | 2422 Glenarm Pl, Denver, CO 80205-3129 | 2017-12-06 |
| 1326494451 | Fort Collins Kids Dentistry | Dentist | 313 Wood St, Fort Collins, CO 80521-1954 | 2016-05-07 |
| 1114307899 | Denver Anesthesia Dentistry | Dentist | 5420 Lakeshore Dr, Littleton, CO 80123 | 2015-06-08 |
| 1871831594 | Nishant Chauhan | Dentist | 5005 S Kipling Pkwy, Ste A7-394, Littleton, CO 80127-7930 | 2013-01-31 |
| 1689935975 | Bradley W Green | Dentist | 1745 Shea Center Dr Fl 4, Highlands Ranch, CO 80129-1537 | 2012-06-03 |
| 1942868690 | Rocky Mountain Dental Anesthesia | Dentist | 811 Brickyard Cir, Golden, CO 80403-8058 | 2019-05-29 |
| 1285070938 | Philip M. Yen | Dentist | 8301 E Prentice Ave Ste 215, Greenwood Village, CO 80111-2990 | 2013-05-21 |
| 1780938274 | Carepoint Anesthesia Group LLC | Dentist | 8301 E Prentice Ave Ste 215, Greenwood Village, CO 80111-2990 | 2012-11-05 |
| Find all providers with the same taxonomy | ||||
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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.