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ICONIC DENTAL INC
NPI 1497103691
Dentist - General Practice in Walsenburg, CO

Active since May 27, 2016
624 MAIN ST, WALSENBURG, CO 81089(719) 695-1004(719) 695-1006 Get Directions Write a Review

NPPES record last updated: May 27, 2016. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Iconic Dental Inc NPPES

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

ICONIC DENTAL INC (NPI 1497103691) is a healthcare organization registered as a general practice in Walsenburg, Colorado and active in the NPI registry since May 2016. The organization lists Taci Cooper, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1497103691
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameICONIC DENTAL INC
Location Address624 MAIN STWalsenburg, CO 81089-2136
Mailing Address624 Main StWalsenburg, CO 81089-2136 · (719) 695-1004 · Fax (719) 695-1006
Phone(719) 695-1004
Fax(719) 695-1006
Organization SubpartNo
Authorized OfficialTaci CooperOffice Manager · (719) 241-3140
Enumeration DateMay 27, 2016
✔ NPI 1497103691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
624 MAIN ST, Walsenburg, CO 81089
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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.

DR. NATHAN HEYWOOD DDS
Dentist
624 MAIN ST
WALSENBURG, CO 81089
Huerfano County (719) 695-1004
SHOFF SMILES, PC
Dentist (General Practice)
624 MAIN ST
WALSENBURG, CO 81089
Huerfano County (719) 695-1044
DR. JAMES SHOFF DMD
Dentist (General Practice)
624 MAIN ST
WALSENBURG, CO 81089
Huerfano County (719) 695-1004

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 Iconic Dental Inc's NPI number?

The NPI number for Iconic Dental Inc is 1497103691. It was assigned to this organization in the NPPES registry on May 27, 2016.

Where is Iconic Dental Inc located?

Iconic Dental Inc is located at 624 Main St, Walsenburg, CO 81089. The listed phone number is (719) 695-1004.

What is Iconic Dental Inc'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 Iconic Dental Inc was last updated on May 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.