NORTHEAST FAMILY DENTAL CLINIC – NPI #1154486272
Clinic/Center

NORTHEAST FAMILY DENTAL CLINIC is an AHC clinic located in HAXTUN, CO. NPPES has assigned the NPI number 1154486272 to NORTHEAST FAMILY DENTAL CLINIC on December 27, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHEAST FAMILY DENTAL CLINIC below.

NPI Profile for
NORTHEAST FAMILY DENTAL CLINIC

NPI Number
1154486272
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTHEAST FAMILY DENTAL CLINIC
Primary location
115 SOUTH COLORADO AVE
HAXTUN, CO 80731
Phone: (970) 774-7999 Fax: (970) 774-7997
Mailing address
PO BOX 248
HAXTUN, CO 80731
Phone: (970) 774-7999 Fax: (970) 774-7997
Organization Subpart
No
Authorized Official
AARON WOOD
CEO
Phone: (970) 774-6123
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 CO CO8895

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.