PRESTIGE DENTAL LLC (NPI# 1023412095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023412095 |
| Entity Type | Organization |
| Organization Name | PRESTIGE DENTAL LLC |
| Other Organization Name | PRESTIGE DENTAL CENTERS |
| Practice Address |
3208 N Academy Blvd Ste 110 Colorado Springs CO 80917-5171 |
| Practice Telephone | 7195973700 |
| Practice Fax Number | 7195977507 |
| Mailing Telephone | 7195973700 |
| Mailing Fax Number | 7195977507 |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |
| Authorized Official Name | MRS. DIANA D SHAY (OFFICE MANAGER) |
| Authorized Official Telephone | 7195973700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 201875 | CO | Dental Providers |
| N | 124Q00000X | Dental Hygienist | DH000905418 | CO | Dental Providers |
| Y | 122300000X | Dentist | 7989 | CO | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 97401862 | 05 | |
| CO | 38873362 | 05 | |
| CO | 65426061 | 05 |
| Other Name | Type Code |
|---|---|
| Prestige Dental Centers | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356779052 | Prestige Dental LLC | Clinic/Center | 246 W Girard Ave, Philadelphia, PA 19123-1538 | 2013-10-16 |
| Street Address |
3208 N ACADEMY BLVD STE 110 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80917-5171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910499 | Select Physical Therapy of Colorado Springs Lp | Durable Medical Equipment & Medical Supplies | 5660 Barnes Road, Suite 116, Colorado Springs, CO 80917 | 2020-07-30 |
| 1043796774 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3475 North Academy Blvd, Colorado Springs, CO 80917 | 2018-07-16 |
| 1598273153 | Ariana Goemaere | Behavior Technician | 3535 Parkmoor Village Dr, Colorado Springs, CO 80917 | 2018-01-17 |
| 1366959769 | Behavioral Health Consultants, Inc. | Clinic/Center | 3210 North Academy Blvd, Suite 3, Colorado Springs, CO 80917 | 2018-01-08 |
| 1558870030 | Falisha Rief | Assistant Behavior Analyst | 2790 North Academy Blvd, Suite 180, Colorado Springs, CO 80917 | 2017-09-27 |
| 1407374655 | Christina Otto | Assistant Behavior Analyst | 2790 North Academy, Suite 180, Colorado Springs, CO 80917 | 2017-09-07 |
| 1992155956 | Georgina Segura | Nurse Practitioner | 5135 Iron Horse Trl, Colorado Springs, CO 80917 | 2016-06-20 |
| 1952685182 | Barbara Hazard Henning | Pharmacist | 3840 N Academy Blvd, Colorado Springs, CO 80917 | 2011-10-06 |
| 1659651412 | Nicole Blakesley | Psychologist | 3264 Vail Pass Drive, Colorado Springs, CO 80917 | 2011-08-25 |
| 1427360254 | Austinbluffs Dental Prof. LLC | Dentist | 3952 North Academy, Colorado Springs, CO 80917 | 2010-07-09 |
| Find all providers in zip 80917 | ||||
| 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 |
|---|---|---|---|---|
| 1659979375 | Kyle Richardson | Dentist | 5865 Lehman Dr Ste 200, Colorado Springs, CO 80918-3412 | 2020-10-14 |
| 1740751460 | Audubon Dental Sleep Solutions LLC | Dentist | 2960 N Circle Dr Ste 105, Colorado Springs, CO 80909-1163 | 2018-12-06 |
| 1053898437 | Lorraine Julienne Labayen | Dentist | 7795 Dublin Blvd, Colorado Springs, CO 80923-7592 | 2018-07-27 |
| 1780178442 | Denise Ivonne Clare | Dentist | 4451 Venetucci Blvd Unit 160, Colorado Springs, CO 80906-4056 | 2018-06-17 |
| 1780185462 | Kenneth C. Pollary Dds Pllc | Dentist | 3204 N Academy Blvd Ste 210, Colorado Springs, CO 80917-5163 | 2018-02-27 |
| 1881119220 | Egbert and Stilson Dental Pllc | Dentist | 9235 N Union Blvd Ste 170, Colorado Springs, CO 80920-7833 | 2017-08-07 |
| 1942752837 | Robert Kemp Van Wagenen | Dentist | 5944 Huerfano Dr, Colorado Springs, CO 80923-3437 | 2016-10-26 |
| 1477005494 | Preferred Dental | Dentist | 5752 Palmer Park Blvd, Colorado Springs, CO 80915-1511 | 2016-10-25 |
| 1306396551 | Rota Advanced Dental Care | Dentist | 6210 Woodmen Park Vw, Colorado Springs, CO 80923-2616 | 2016-10-12 |
| 1891248506 | Nicholas Allan Wyatt | Dentist | 685 Citadel Dr E Ste 302, Colorado Springs, CO 80909-5316 | 2016-07-28 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80917 |
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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.