Healthcare Provider Details

I. General information

NPI: 1407633399
Provider Name (Legal Business Name): FALCON PEDIATRIC DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 09/25/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7685 MCLAUGHLIN RD
PEYTON CO
80831-4751
US

IV. Provider business mailing address

7833 FRENCH RD
COLORADO SPRINGS CO
80920-8002
US

V. Phone/Fax

Practice location:
  • Phone: 719-749-9001
  • Fax: 719-749-9002
Mailing address:
  • Phone: 402-547-6552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. COLBY BECK
Title or Position: OWNER
Credential: DDS
Phone: 402-547-6552