Provider Demographics
NPI:1659675056
Name:APPLE ORTHODONTIX
Entity Type:Organization
Organization Name:APPLE ORTHODONTIX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:TALOUMIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:719-538-4671
Mailing Address - Street 1:1694 E CHEYENNE MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4050
Mailing Address - Country:US
Mailing Address - Phone:719-538-4671
Mailing Address - Fax:719-538-4672
Practice Address - Street 1:1694 E CHEYENNE MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4050
Practice Address - Country:US
Practice Address - Phone:719-538-4671
Practice Address - Fax:719-538-4672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty