ADVANTAGE DENTAL GROUP (NPI# 1205276128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205276128 |
| Entity Type | Organization |
| Organization Name | ADVANTAGE DENTAL GROUP |
| Practice Address |
1800 Fortino Blvd Unit 1 Pueblo CO 81008-1891 |
| Practice Telephone | 7195451400 |
| Practice Fax Number | 7195455153 |
| Mailing Telephone | 7195451400 |
| Mailing Fax Number | 7195455153 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-06-25 |
| Authorized Official Name | ERIC L. BERRY (OWNER) |
| Authorized Official Telephone | 7195451400 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 105682 | CO | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ADVANTAGE DENTAL GROUP, P.C. | 442 Sw Umatilla Ave Ste 200, Redmond, OR 97756-7039 |
| Oregon Corporations, Companies and Business Names | ADVANTAGE DENTAL GROUP, P.C. | 442 Sw Umatilla Ave Ste 200, Redmond, OR 97756 |
| Street Address |
1800 FORTINO BLVD UNIT 1 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| 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 |
|---|---|---|---|---|
| 1497382303 | Pueblo Family Dentistry Pllc | Dentist | 701 N Grand Avenue, Suite B, Pueblo, CO 81003 | 2020-03-23 |
| 1326673880 | Charles Wohlwend Ddspc | Dentist | 1044 Eagleridge Blvd, Pueblo, CO 81008-2130 | 2020-03-05 |
| 1245758168 | Jenny C Alas | Dentist | 2603 Vinewood Lane, Pueblo, CO 81005 | 2017-08-30 |
| 1891222402 | Pueblo Dental & Braces | Dentist | 1345 S Pueblo Blvd, Pueblo, CO 81005-1508 | 2017-05-12 |
| 1346798923 | Dr Tina L Skinner Dds Ms PC | Dentist | 2047 Columbia Dr, Pueblo, CO 81005-3279 | 2016-09-13 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1346608197 | Michael E Allen | Dentist | 1800 Fortino Blvd Unit 2, Pueblo, CO 81008-1891 | 2016-02-08 |
| 1851777304 | James Kellan Villalon | Dentist | 1225 N Main St Ste 207, Pueblo, CO 81003-2857 | 2015-08-07 |
| 1689080848 | Gregory Ragulsky | Dentist | 3939 Sandalwood Ln, Pueblo, CO 81005-2586 | 2014-07-09 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| Find all providers in PUEBLO | ||||
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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.