Provider Demographics
NPI:1578782652
Name:DR JOSE M ARANGO DDS MS
Entity Type:Organization
Organization Name:DR JOSE M ARANGO DDS MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:ARANGO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:719-579-9773
Mailing Address - Street 1:4731 OPUS DR.
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906
Mailing Address - Country:US
Mailing Address - Phone:719-579-9773
Mailing Address - Fax:719-579-9768
Practice Address - Street 1:4731 OPUS DR.
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906
Practice Address - Country:US
Practice Address - Phone:719-579-9773
Practice Address - Fax:719-579-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO79051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO971448OtherUNITED CONCORDIA ID P
CO83284745Medicaid
CO707114OtherUNITED CONCORDIA ID CS
CO83284745Medicaid