DR. ANIL JOSEPH IDICULLA (NPI# 1558438945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558438945 |
| Entity Type | Individual |
| Full Name | DR. ANIL JOSEPH IDICULLA |
| Credential | D.M.D. |
| Practice Address |
11275 E Mississippi Ave Suite 2-n Aurora CO 80012-3263 |
| Mailing Address |
4550 Cherry Creek South Dr Apartment 2200 Denver CO 80246-1554 |
| Practice Telephone | 3033414878 |
| Mailing Telephone | 2159080008 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
9309 | CO | Dental Providers |
| Street Address |
11275 E MISSISSIPPI AVE SUITE 2-N |
| City | AURORA |
| State | CO |
| Zip Code | 80012-3263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295736056 | James J Reynolds | Dentist | 11275 E Mississippi Ave, Suite 2s3, Aurora, CO 80012-3263 | 2005-08-02 |
| 1053718999 | Noelle Dilgarde | Nurse Practitioner | 11275 E Mississippi Ave, Suite 2-s-3, Aurora, CO 80012-3263 | 2014-11-20 |
| 1225434590 | Exclusive Healthcare LLC | Home Health | 11275 E Mississippi Ave, Suite 1s8, Aurora, CO 80012-3263 | 2014-11-13 |
| 1366856197 | Jean Martinez | Dental Hygienist | 11275 E Mississippi Ave, 1w2, Aurora, CO 80012-3263 | 2014-06-19 |
| 1740552371 | Mile High Dentistry | Dentist | 11275 E Mississippi Ave, #2w1, Aurora, CO 80012-3263 | 2012-01-27 |
| 1033496609 | Bethanne J Beisner | Massage Therapist | 11275 E Mississippi Ave, 1s8, Aurora, CO 80012-3263 | 2011-11-10 |
| 1942525902 | Colorado Primary Care Clinic Inc | Nurse Practitioner | 11275 E Mississippi Ave, 2 South 6, Aurora, CO 80012-3263 | 2010-04-02 |
| 1497928527 | Village Park Dental PC | Dentist | 11275 E Mississippi Ave, 2 South 3, Aurora, CO 80012-3263 | 2008-04-09 |
| 1679695811 | Steven Craig Karden | Dentist | 11275 E Mississippi Ave, Suite 1e3, Aurora, CO 80012 | 2007-04-06 |
| 1407924962 | Anex Medical Services LLC | Durable Medical Equipment & Medical Supplies | 11275 E Mississippi Ave, Suite #1-n-4, Aurora, CO 80012-3263 | 2006-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225650765 | Veronica Kabuika | Specialist/Technologist, Other | 6792 E Tennessee Ave, Suite 645, Denver, CO 80012 | 2020-05-07 |
| 1811547631 | Aurora Dental and Orthodontics Pllc | Dentist | 15000 E Mississippi Ave, Aurora, CO 80012 | 2019-09-13 |
| 1306362108 | Melynda Barrios | Massage Therapist | 11912 E Nevada Cir, Aurora, CO 80012 | 2017-08-14 |
| 1851815633 | Gabriela Alejandra Perez-saenz | Audiologist | 1550 S. Potomac St. #305, Aurora, CO 80012 | 2017-08-02 |
| 1568991511 | Iora Health Colorado, P.C. | Internal Medicine | 1080 S. Sable Blvd., Aurora, CO 80012 | 2017-06-05 |
| 1275069734 | Sandra Pacheco | Case Manager/Care Coordinator | 10782 E Alameda Avenue, Aurora, CO 80012 | 2017-05-03 |
| 1578002010 | Green Taxi Corporation | Taxi | 10 S Havana St #103, Aurora, CO 80012 | 2017-02-16 |
| 1104372713 | Moss LLC | Non-emergency Medical Transport (VAN) | 950 S Cimmaron Way Unit K-201, Aurora, CO 80012 | 2016-09-01 |
| 1023461647 | Thompson Sowash | Optometrist | 13955 E Mississippi, Aurora, CO 80012 | 2016-07-19 |
| 1598117731 | Act of Kindness LLC | Respite Care | 1010 S Joliet Street Suite #101, Aurora, CO 80012 | 2016-07-12 |
| Find all providers in zip 80012 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336779164 | Orthodontic Experts, Ltd | Dentist | 2987 Kirk Rd Ste 103a, Aurora, IL 60502-6014 | 2020-01-21 |
| 1356850002 | Kathleen Elverman | Dentist | 13065 East 17th Avenue, Mail Stop F846, Aurora, CO 80045 | 2017-09-26 |
| 1073042370 | Theresa Shaver Orthodontics | Dentist | 5001 S Parker Rd Ste 201, Aurora, CO 80015-1183 | 2017-06-08 |
| 1700255676 | Colorado Orthodontics | Dentist | 2993 S Peoria St Ste 260, Aurora, CO 80014-5710 | 2015-09-21 |
| 1932447026 | Winsmile Orthodontics & Cosmetic Dentistry | Dentist | 633 S Route 59, Aurora, IL 60504-8169 | 2013-01-23 |
| 1972866077 | Kristen Lowe | Dentist | 13123 E 16th Ave # 240, Aurora, CO 80045-7106 | 2012-06-22 |
| 1851626691 | Gary Lippincott | Dentist | 70 S Constitution Dr, 102, Aurora, IL 60506-7341 | 2009-10-13 |
| 1255666376 | Smile 5 Professionals LLC | Dentist | 10401 East Colfax Ave, Aurora, CO 80010 | 2009-10-07 |
| 1396940003 | Daniel John Rejman | Dentist | 15159 E Colfax Ave Unit B, Aurora, CO 80011-5707 | 2007-06-21 |
| 1194845602 | Roger B Elton | Dentist | 5657 S Himalaya St Ste 110, Aurora, CO 80015-5308 | 2007-03-29 |
| 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.