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EAGLERIDGE DENTAL
NPI 1487288106
Dentist in Walsenburg, CO

Active since March 03, 2020
104 E 6TH ST, WALSENBURG, CO 81089(719) 738-2544(719) 738-3747 Get Directions Write a Review

NPPES record last updated: March 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eagleridge Dental NPPES

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

EAGLERIDGE DENTAL (NPI 1487288106) is a healthcare organization registered as a dentist in Walsenburg, Colorado and active in the NPI registry since March 2020. The organization maintains a secondary practice location in Pueblo and lists Charles Wohlwend, Dentist, as its authorized official.

NPPES Registry Identity

NPI1487288106
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameEAGLERIDGE DENTAL
Location Address104 E 6TH STWalsenburg, CO 81089-2020
Mailing Address1044 Eagleridge BlvdPueblo, CO 81008-2130 · (719) 542-1212 · Fax (719) 544-3854
Phone(719) 738-2544
Fax(719) 738-3747
Organization SubpartNo
Authorized OfficialCharles WohlwendDentist · (719) 542-1212
Enumeration DateMarch 3, 2020
NPPES CertifiedMarch 3, 2020
✔ NPI 1487288106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
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.
104 E 6TH ST, Walsenburg, CO 81089
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Secondary Practice Location 1

Location 11044 Eagleridge BlvdPueblo, CO 81008-2130 · Phone (719) 542-1212 · Fax (719) 544-3854

Other Identifiers 1

Medicaid10CO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

CHARLES WOHLWEND DDSPC
Dentist
104 E 6TH ST
WALSENBURG, CO 81089
Huerfano County (719) 738-2544

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 Eagleridge Dental's NPI number?

The NPI number for Eagleridge Dental is 1487288106. It was assigned to this organization in the NPPES registry on March 3, 2020.

Where is Eagleridge Dental located?

Eagleridge Dental is located at 104 E 6th St, Walsenburg, CO 81089. The listed phone number is (719) 738-2544.

What is Eagleridge Dental's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Eagleridge Dental was last updated on March 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.