COAL CREEK ORAL SURGERY AND DENTAL IMPLANT CENTER, PLLC (NPI# 1154864106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154864106 |
| Entity Type | Organization |
| Organization Name | COAL CREEK ORAL SURGERY AND DENTAL IMPLANT CENTER, PLLC |
| Practice Address |
1771 Cherokee Trl Lafayette CO 80026-7088 |
| Practice Telephone | 7205882505 |
| Mailing Telephone | 7205882505 |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2016-11-23 |
| Authorized Official Name | DR. CURTIS J HAYES (OWNER) |
| Authorized Official Telephone | 7205882505 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
8636 | CO | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 84870052 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Coal Creek Oral Surgery and Dental Implant Center, PLLC | 1771 Cherokee Trl, Lafayette, CO 80026 |
| Street Address |
1771 CHEROKEE TRL |
| City | LAFAYETTE |
| State | CO |
| Zip Code | 80026-7088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528671690 | Julia Michele Colton | Occupational Therapist | 110 S. Roosevelt Ave, Lafayette, CO 80026 | 2020-08-28 |
| 1265045900 | Amber M. Roter | Social Worker | 588 N Us-287 Co, Suite 200, Lafayette, CO 80026 | 2020-08-24 |
| 1669008314 | Dr. Sunda Friedman Tebockhorst Psychologicl Services, Ltd | Clinic/Center | 588 N Hwy 287, Suite 200, Lafayette, CO 80026 | 2020-03-13 |
| 1659918910 | Emily Nicole Pearson | Behavior Technician | 961 Sandstone Circle, Lafayette, CO 80026 | 2019-12-05 |
| 1790320612 | Gs Campus Asc, LLC | Clinic/Center | Lafayette Surgery Center, 340 Exempla Circle, Suite #400, Lafayette, CO 80026 | 2019-11-14 |
| 1639711864 | Martina Christina Holzach | Student in an Organized Health Care Education/Training Program | 1455 Dixon Ave, Suite #300, Lafayette, CO 80026 | 2019-10-09 |
| 1104474055 | 2nd Star Counseling | Clinic/Center | 260 S. Public Rd, Lafayette, CO 80026 | 2019-09-03 |
| 1912460015 | Premier Eye Surgery Center of Colorado, LLC | Clinic/Center | 1050 W. South Boulder Road, Lafayette, CO 80026 | 2019-04-08 |
| 1144704883 | Nikole J Randolph | Nutritionist | 2770 Dagny Way Suite 210, Lafayette, CO 80026 | 2018-09-19 |
| 1609388842 | Claro Scientific Laboratories Corp | Clinical Medical Laboratory | 1408 Horizon Ave Ste 101, Lafayette, CO 80026 | 2017-10-27 |
| Find all providers in zip 80026 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1578089603 | Ardoin-kennedy LLC | Dentist | 203 A Energy Parkway, Lafayette, LA 70508 | 2017-08-21 |
| 1063629988 | Brett A Henrikson | Dentist | 2 Executive Dr Ste A, Lafayette, IN 47905-4859 | 2007-05-17 |
| 1316169030 | Hiram A. Mcconnell | Dentist | 1231 Coolidge Blvd, Lafayette, LA 70503-2620 | 2007-05-03 |
| 1861523441 | Bruce A Schneider | Dentist | 117 Rue Fontaine, Lafayette, LA 70508-5744 | 2007-03-08 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1093808594 | Keith R. Gronbach, D.d.s., Inc. | Dentist | 3799 Mt Diablo Blvd, Lafayette, CA 94549-3538 | 2006-10-02 |
| 1104920453 | Christian Matthew Steffey | Dentist | 2020 Union St Ste 200, Lafayette, IN 47904-2694 | 2006-09-08 |
| 1780600031 | Mark Alan Welch | Dentist | 200 Republic Ave, I, Lafayette, LA 70508-6826 | 2006-07-13 |
| 1033142872 | Edward A Neupert IIi | Dentist | 3839 W Congress St Ste C, Lafayette, LA 70506-6000 | 2006-07-07 |
| Find all providers in LAFAYETTE | ||||
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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.