COLORADO DENTAL SPECIALIST PRACTICE, LLC (NPI# 1518511146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518511146 |
| Entity Type | Organization |
| Organization Name | COLORADO DENTAL SPECIALIST PRACTICE, LLC |
| Practice Address |
18121 E Hampden Ave Unit E Aurora CO 80013-3591 |
| Practice Telephone | 3033175335 |
| Mailing Telephone | 3033175335 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |
| Authorized Official Name | MICHELLE JOHNSON (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 5093158338 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLORADO DENTAL SPECIALIST PRACTICE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Colorado Dental Specialists | Doing Business As Name - Organization |
| Colorado Endodontic Group | Doing Business As Name - Organization |
| Colorado Orthodontic Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649825886 | Colorado Dental Specialist Practice, LLC | Dentist | 6110 Barnes Rd, Colorado Springs, CO 80922-2600 | 2019-08-05 |
| 1568017077 | Colorado Dental Specialist Practice, LLC | Dentist | 3715 Bloomington St Unit 160, Colorado Springs, CO 80922-3207 | 2019-08-02 |
| 1831743459 | Colorado Dental Specialist Practice, LLC | Dentist | 8085 Fountain Mesa Rd, Fountain, CO 80817-1591 | 2019-07-31 |
| 1184278715 | Colorado Dental Specialist Practice, LLC | Dentist | 3095 S Parker Rd Ste 150, Aurora, CO 80014-2917 | 2019-07-31 |
| 1780238311 | Colorado Dental Specialist Practice, LLC | Dentist | 1160 W Ash St, Windsor, CO 80550-4666 | 2019-07-31 |
| 1740834381 | Colorado Dental Specialist Practice, LLC | Dentist | 1005 W 120th Ave Ste 800, Westminster, CO 80234-2747 | 2019-07-31 |
| 1407400039 | Colorado Dental Specialist Practice, LLC | Dentist | 2800 E 136th Ave, Thornton, CO 80241-3417 | 2019-07-31 |
| 1841844479 | Colorado Dental Specialist Practice, LLC | Dentist | 3955 E 120th Ave Ste B, Thornton, CO 80233-2075 | 2019-07-31 |
| 1497309058 | Colorado Dental Specialist Practice, LLC | Dentist | 3236 Centennial Blvd, Colorado Springs, CO 80907-4077 | 2019-07-31 |
| 1326692955 | Colorado Dental Specialist Practice, LLC | Dentist | 3550 W 38th Ave Ste 50, Denver, CO 80211-2000 | 2019-07-31 |
| Street Address |
18121 E HAMPDEN AVE UNIT E |
| City | AURORA |
| State | CO |
| Zip Code | 80013-3591 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013564384 | My Local Colorado Dental Practice, LLC | Dentist | 18121 E Hampden Ave Unit E, Aurora, CO 80013-3591 | 2019-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558901819 | Raeaje Austin | Non-emergency Medical Transport (VAN) | 2196 S Joplin Way, Aurora, CO 80013 | 2020-01-14 |
| 1164085114 | Luwam Tekle Asfha | Non-emergency Medical Transport (VAN) | 2667 S Lewiston St, Aurora, CO 80013 | 2019-04-16 |
| 1700324183 | Abdlkerim Idris | Non-emergency Medical Transport (VAN) | 3809 S Uravan St, Aurora, CO 80013 | 2017-02-06 |
| 1467908160 | Vanessa Andriott Aranda | Social Worker | 3431 S Genoa St, Aurora, CO 80013 | 2016-09-01 |
| 1326401100 | Bba Transportation | Non-emergency Medical Transport (VAN) | 2534 S. Fundy Cir., Aurora, CO 80013 | 2016-03-30 |
| 1013372770 | Yemane Aregawi | Contractor | 2780 S Ensenada Ct, Aurora, CO 80013 | 2015-12-23 |
| 1649642539 | Stephanie Boisvert | Physician Assistant | 18890 East Hamden Ave, Aurora, CO 80013 | 2015-10-30 |
| 1689042665 | Brittany Stone | Respiratory Therapist, Registered | 3810 S Ceylon Way, Aurora, CO 80013 | 2015-09-09 |
| 1487039657 | Wondemneh Alemneh Deresse | Non-emergency Medical Transport (VAN) | 19142 E, Hampden Dr, Aurora, CO 80013 | 2015-07-29 |
| 1225410855 | Biruk Hailu | Non-emergency Medical Transport (VAN) | 2520 S Flanders Ct, Aurora, CO 80013 | 2015-06-19 |
| Find all providers in zip 80013 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457656159 | Randolph Scott Ziegler | Dentist | 13065 E 17th Ave Ste F847, Room 130, Aurora, CO 80045-2534 | 2011-01-11 |
| 1891927307 | Jonathan Charles Boynton | Dentist | 13065 E 17th Ave Rm 111, Aurora, CO 80045-2532 | 2009-08-17 |
| 1477604478 | Robert John Denny | Dentist | 14001 E. Iliff Ave., Ste. 104, Aurora, CO 80014-1424 | 2007-01-16 |
| 1962580340 | Robert M Pick | Dentist | 95 Trade St, #104, Aurora, IL 60504 | 2006-11-01 |
| 1255305116 | Charles Anthony Powell | Dentist | 13065 E 17th Ave Rm 130k, Mail Stop F847, Aurora, CO 80045-2532 | 2006-02-15 |
| 1508837410 | Lonnie Johnson | Dentist | 1635 Ursula St, Aurora, CO 80010-7402 | 2006-01-30 |
| 1316396518 | Grand Dental Associates, P.C. | Dentist | 1780 N Farnsworth Ave, Aurora, IL 60505-1576 | 2016-06-08 |
| 1689029761 | Lauren Metzger | Dentist | 13065 E 17th Ave, Mail Stop F-850, Room 111, Aurora, CO 80045-2532 | 2016-04-26 |
| 1982006763 | Chacon Dental Group | Dentist | 3535 E New York St, Aurora, IL 60504-4465 | 2014-09-23 |
| 1528303484 | Elite Periodontics PC | Dentist | 2124 Ogden Ave, Suite 104, Aurora, IL 60504-7514 | 2012-12-04 |
| Find all providers in AURORA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.