MY LOCAL COLORADO DENTAL PRACTICE, LLC (NPI# 1669026332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669026332 |
| Entity Type | Organization |
| Organization Name | MY LOCAL COLORADO DENTAL PRACTICE, LLC |
| Practice Address |
1600 23rd Ave Ste 200 Greeley CO 80634-6071 |
| Practice Telephone | 9703534329 |
| Mailing Telephone | 9703534329 |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-30 |
| Authorized Official Name | MICHELLE JOHNSON (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 5093158338 |
| Is Organization Subpart | Y |
| Parent Organization Name | MY LOCAL COLORADO DENTAL PRACTICE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Greeley Dental Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952941650 | My Local Colorado Dental Practice, LLC | Dentist | 12031 Tejon St Ste 100, Westminster, CO 80234-2306 | 2020-01-10 |
| 1891335964 | My Local Colorado Dental Practice, LLC | Dentist | 1727 N Gilpin St, Denver, CO 80218-1205 | 2020-01-07 |
| 1245870336 | My Local Colorado Dental Practice, LLC | Dentist | 264 Union Blvd Ste 200, Lakewood, CO 80228-1970 | 2020-01-07 |
| 1396399069 | My Local Colorado Dental Practice, LLC | Dentist | 1691 Coalton Rd, Superior, CO 80027-4681 | 2019-07-30 |
| 1679127492 | My Local Colorado Dental Practice, LLC | Dentist | 200 Quebec St Unit 105, Denver, CO 80230-7144 | 2019-07-30 |
| 1265086920 | My Local Colorado Dental Practice, LLC | Dentist | 7505 E 35th Ave Unit 304, Denver, CO 80238-2460 | 2019-07-30 |
| 1376197046 | My Local Colorado Dental Practice, LLC | Dentist | 3541 E Harmony Rd Ste 130, Fort Collins, CO 80528-8816 | 2019-07-30 |
| 1043864705 | My Local Colorado Dental Practice, LLC | Dentist | 5021 S Jellison Way Unit C, Littleton, CO 80123-7377 | 2019-07-30 |
| 1528612298 | My Local Colorado Dental Practice, LLC | Dentist | 7685 Mclaughlin Rd Ste 100, Falcon, CO 80831-4751 | 2019-07-30 |
| 1417501180 | My Local Colorado Dental Practice, LLC | Dentist | 8410 Wadsworth Blvd Unit G, Arvada, CO 80003-0918 | 2019-07-30 |
| Street Address |
1600 23RD AVE STE 200 |
| City | GREELEY |
| State | CO |
| Zip Code | 80634-6071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528066404 | Charles William Johnson | Dentist | 1600 23rd Ave Ste 200, Greeley, CO 80634-6071 | 2005-07-13 |
| 1861022162 | Jennifer Kala | Dental Hygienist | 1600 23rd Ave Ste 200, Greeley, CO 80634-6071 | 2020-01-25 |
| 1396399929 | Colorado Dental Specialist Practice, LLC | Dentist | 1600 23rd Ave Ste 200, Greeley, CO 80634-6071 | 2019-07-31 |
| 1467597021 | Colorado Dhca Greeley, Pllc | Dentist | 1600 23rd Ave Ste 200, Greeley, CO 80634-6071 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707843 | Witting Medical, LLC | Pathology | 17 Dos Rios, Greeley, CO 80634 | 2020-07-15 |
| 1730706102 | Heart Centered Counseling | Counselor | 1770 W 25th Street #206, Greeley, CO 80634 | 2020-07-01 |
| 1396374237 | Kidstuff Child and Family Counseling, P.C. | Counselor | 1770 25th Ave., Ste. 102, Greeley, CO 80634 | 2020-04-03 |
| 1164055745 | Stephanie Alexis Balunda | Speech-Language Pathologist | Uchealth Physical Therapy and Rehabilitation Clinic, 6767 West 29th St., Greeley, CO 80634 | 2020-02-21 |
| 1407413727 | Stephen P Street Pllc | Counselor | 4657 W. 20th Street, Unit B, Greeley, CO 80634 | 2019-05-22 |
| 1043797749 | Burt Stewart Dmd Pllc | Clinic/Center | 6937 West 10th Street, Greeley, CO 80634 | 2018-07-25 |
| 1164913885 | Innovations Pediatric Therapy, LLC | Occupational Therapist | 3403 W 7th St Apt A, Greeley, CO 80634 | 2018-05-29 |
| 1003305319 | Austin Michael Lake | Physical Therapist | 4681 W 20th St Unit 202b, Greeley, CO 80634 | 2018-05-02 |
| 1225542004 | Kevin Lichner | Specialist/Technologist | 522 28th Ave, Greeley, CO 80634 | 2017-11-30 |
| 1538683909 | Stacie Jackson | Physician Assistant | 6500 West 29th St Ste 106, Greeley, CO 80634 | 2017-07-27 |
| Find all providers in zip 80634 | ||||
| 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 |
|---|---|---|---|---|
| 1992321400 | Taha Syed Aziz | Dentist | 3400 W 16th St # 8e, Greeley, CO 80634-6862 | 2020-06-20 |
| 1568972883 | G Dental LLC | Dentist | 2918 W 10th St Ste 5, Greeley, CO 80634-5457 | 2017-10-02 |
| 1801324298 | Shawn Michael Custer | Dentist | 3400 W 16th St Ste 8e, Greeley, CO 80634-6862 | 2017-05-30 |
| 1679017560 | Dentists of Greeley, LLP | Dentist | 4421 Centerplace Dr, Suite A, Greeley, CO 80634-3756 | 2016-12-12 |
| 1316311012 | Cornerstone Orthodontics, LLC | Dentist | 1825 56th Avenue Unit A, Greeley, CO 80634 | 2015-11-18 |
| 1023421435 | Matthew Lee | Dentist | 2525 W 16th St Ste A, Greeley, CO 80634-4951 | 2014-06-04 |
| 1750678439 | Greeley Modern Dentistry, LLP | Dentist | 6632 10th Street Suite 101, Greeley, CO 80634 | 2011-07-01 |
| 1013132737 | Gregory Lyle Obermann | Dentist | 7251 West 20th Street, Bldg.h-2, Greeley, CO 80634 | 2007-04-16 |
| 1568584142 | James M. Shaddock IIi | Dentist | 516 N. Brisbane Ave, Greeley, CO 80634 | 2007-04-04 |
| 1780705939 | Steven Eugene Bagley | Dentist | 913 27th Ave, Greeley, CO 80634-5808 | 2007-04-03 |
| Find all providers in GREELEY | ||||
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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.