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PUEBLO WEST DENTAL CARE
NPI 1255795464
Dentist - General Practice in Pueblo West, CO

Active since April 13, 2016
120 S STARDUST DR, PUEBLO WEST, CO 81007(719) 547-4474(719) 547-4710 Get Directions Write a Review

NPPES record last updated: April 13, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Pueblo West Dental Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PUEBLO WEST DENTAL CARE (NPI 1255795464) is a healthcare organization registered as a general practice in Pueblo West, Colorado and active in the NPI registry since April 2016. The organization lists Brady Sefcik, Dds/owner, as its authorized official.

NPPES Registry Identity

NPI1255795464
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameHEADWATERS DENTAL MANAGEMENT
Location Address120 S STARDUST DRPueblo West, CO 81007-1631
Mailing Address120 S Stardust DrPueblo West, CO 81007-1631 · (719) 547-4474 · Fax (719) 547-4710
Phone(719) 547-4474
Fax(719) 547-4710
Organization SubpartNo
Authorized OfficialBrady SefcikDds/owner · (719) 547-4474
Enumeration DateApril 13, 2016
✔ NPI 1255795464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CO · 00202298
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

120 S STARDUST DR, Pueblo West, CO 81007
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Other Names 1

Doing Business AsPueblo West Dental Care

Other Identifiers 1

Medicaid80780580CO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PUEBLO WEST DENTAL, PROF.LLC
Clinic/Center (Dental)
120 S STARDUST DR
PUEBLO WEST, CO 81007
Pueblo County (719) 547-4474
PUEBLO WEST NEIGHBORHOOD DENTAL
Clinic/Center (Dental)
120 S STARDUST DR
PUEBLO WEST, CO 81007
Pueblo County (719) 547-4474
TAYLOR RANDOLPH ROSS
Dentist (General Practice)
120 S STARDUST DR
PUEBLO WEST, CO 81007
Pueblo County (719) 547-4474

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Headwaters Dental Management's NPI number?

The NPI number for Headwaters Dental Management is 1255795464. It was assigned to this organization in the NPPES registry on April 13, 2016.

Where is Headwaters Dental Management located?

Headwaters Dental Management is located at 120 S Stardust Dr, Pueblo West, CO 81007. The listed phone number is (719) 547-4474.

What is Headwaters Dental Management's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Headwaters Dental Management was last updated on April 13, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.