Palmer Park Dentistry, PLLC
Dentist, General Practice in Colorado Springs, CO. Organization (NPI-2).
Details
- NPI
- 1255141925
- Entity type
- Organization (NPI-2)
- Legal business name
- Palmer Park Dentistry, PLLC
- Organization subpart
- No
- Enumeration date
- Jan 13, 2025
- Certification date
- Jan 13, 2025
- Last updated
- Jan 13, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Palmer Park Dentistry (Doing Business As)
Practice location
3208 N Academy Blvd Ste 140Colorado Springs, CO 80917-5111
Phone 719-301-5303 · Fax 719-301-5303
Mailing address
3208 N Academy Blvd Ste 140Colorado Springs, CO 80917-5111
Phone 719-301-5303 · Fax 719-301-5303
Authorized official
Nick Sundiam
Credentialing Manager
7193005933
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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