SAN JUAN DENTAL LLC – NPI #1538849955
Clinic/Center

SAN JUAN DENTAL LLC is an AHC clinic located in PAGOSA SPRINGS, CO. NPPES has assigned the NPI number 1538849955 to SAN JUAN DENTAL LLC on July 20, 2023. 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

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 SAN JUAN DENTAL LLC below.

NPI Profile for
SAN JUAN DENTAL LLC

NPI Number
1538849955
Enumeration Date

(about 3 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
SAN JUAN DENTAL LLC
Primary location
308 PAGOSA ST
PAGOSA SPRINGS, CO 81147
Phone: (970) 264-9436 Fax:
Mailing address
PO BOX 2336
PAGOSA SPRINGS, CO 81147-2312
Phone: (970) 264-9436 Fax:
Organization Subpart
No
Authorized Official
ERIC SMITH
OWNER
Phone: (970) 264-9436
Updated
Certification Date
Jul 18, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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)

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.