COLORADO DENTAL PROFESSIONALS, LLC (NPI# 1700449436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700449436 |
| Entity Type | Organization |
| Organization Name | COLORADO DENTAL PROFESSIONALS, LLC |
| Other Organization Name | SANGRE DE CRISTO DENTAL CARE |
| Practice Address |
904 Hailey Ln Ste A Pueblo West CO 81007-4456 |
| Practice Telephone | 7192251009 |
| Practice Fax Number | 8888471729 |
| Mailing Telephone | 7194706356 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-07-18 |
| Authorized Official Name | JESSICA BRITT (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLORADO DENTAL PROFESSIONALS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Sangre de Cristo Dental Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477179521 | Colorado Dental Professionals, LLC | Dentist | 13075 Copperhead Trl, Parker, CO 80134-6243 | 2020-06-24 |
| 1578101200 | Colorado Dental Professionals, LLC | Dentist | 8290 S Holly St Ste A, Centennial, CO 80122-4029 | 2019-12-12 |
| 1306487053 | Colorado Dental Professionals, LLC | Dentist | 14823 W 91st Pl, Arvada, CO 80005-1454 | 2019-10-03 |
| 1962059931 | Colorado Dental Professionals, LLC | Dentist | 655 Southpointe Ct Ste 150, Colorado Springs, CO 80906-3859 | 2019-08-23 |
| 1689145609 | Colorado Dental Professionals, LLC | Dentist | 6726 S Revere Pkwy # A140, Centennial, CO 80112-3961 | 2018-12-17 |
| 1326553819 | Colorado Dental Professionals, LLC | Dentist | 2297 State Highway 7, Erie, CO 80516-8009 | 2017-12-06 |
| 1255843975 | Colorado Dental Professionals, LLC | Dentist | 440 Erie Pkwy, Erie, CO 80516 | 2017-11-03 |
| 1477065506 | Colorado Dental Professionals, LLC | Dentist | 7520 Bierstadt Hts Ste 125, Falcon, CO 80831-6177 | 2017-10-30 |
| 1902265382 | Colorado Dental Professionals, LLC | Dentist | 12889 Quebec Street, Thornton, CO 80602 | 2016-02-15 |
| 1720171564 | Colorado Dental Professionals, LLC | Dentist | 6980 Mesa Ridge Parkway, Suite 200, Fountain, CO 80817 | 2006-10-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Colorado Dental Professionals, LLC | 1900 W. Littleton Blvd, Littleton, CO 80120 |
| Street Address |
904 HAILEY LN STE A |
| City | PUEBLO WEST |
| State | CO |
| Zip Code | 81007-4456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811406630 | Southern Colorado Hearing Associates, Inc. | Audiologist | 904 East Hailey Lane, Pueblo West, CO 81007 | 2017-09-25 |
| 1396274361 | Laura Selig | Physical Therapist | 1168 N Thorpe Dr, Pueblo West, CO 81007 | 2017-06-05 |
| 1710351127 | Benjamin Gaines | Speech-Language Pathologist | 1056 W Broken Bow Dr, Pueblo West, CO 81007 | 2015-11-23 |
| 1467861351 | Zoe Grillos | Massage Therapist | 876 S Knox Dr, Pueblo West, CO 81007 | 2014-08-05 |
| 1033454186 | Melissa Lynn Hollis | Occupational Therapy Assistant | 1333 N Blue Lake Ln, Pueblo West, CO 81007 | 2012-11-30 |
| 1336491125 | Patricia Deana Cuadrado | General Practice | 44 E. Spaulding Ave., Pueblo West, CO 81007 | 2012-10-04 |
| 1194088021 | Aaron J Wilson | Chiropractor | 50 S Dunlap Dr, Pueblo West, CO 81007 | 2012-06-15 |
| 1780811893 | Rhonda Renee Grigg | Pediatrics | 332 S Orchard Springs Dr. 150, Pueblo, CO 81007 | 2009-06-16 |
| 1144482191 | Christopher Nicholas Liontas | Dentist | 360 S. Orchard Springs Dr, Pueblo West, CO 81007 | 2008-07-01 |
| 1780855718 | Justin Dean Youngren | Chiropractor | 50 S Dunlap Drive, Pueblo West, CO 81007 | 2008-03-18 |
| Find all providers in zip 81007 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528401635 | Taylor Randolph Ross | Dentist | 120 S Stardust Dr, Pueblo West, CO 81007-1631 | 2013-04-09 |
| 1780930073 | Mark Blaskovich | Dentist | 120 S Crescent Dr, Pueblo West, CO 81007-2787 | 2012-07-24 |
| 1144482191 | Christopher Nicholas Liontas | Dentist | 360 S. Orchard Springs Dr, Pueblo West, CO 81007 | 2008-07-01 |
| 1235335670 | Aaron Levi Murray | Dentist | 141 S. Purcell Blvd, Suite 120, Pueblo West, CO 81007-5121 | 2007-06-22 |
| 1356430714 | Dennis P Driscoll | Dentist | 318 Orchard Springs Dr, Pueblo West, CO 81007 | 2006-10-12 |
| 1255795464 | Headwaters Dental Management | Dentist | 120 S Stardust Dr, Pueblo West, CO 81007-1631 | 2016-04-13 |
| 1710061940 | Mark T House | Dentist | 318 Orchard Springs Dr, Pueblo West, CO 81007 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346848496 | Vantage Pointe Dental Pllc | Dentist | 11410 Via Varra Unit 400, Broomfield, CO 80020-9764 | 2020-10-12 |
| 1295342640 | Union Blvd Dental Pllc | Dentist | 3920 N Union Blvd Ste 380, Colorado Springs, CO 80907-4922 | 2020-09-29 |
| 1548877608 | Elbert Dental Pllc | Dentist | 6140 Tutt Blvd Ste 140, Colorado Springs, CO 80923-3574 | 2020-09-23 |
| 1588279350 | Parker Alan Drake | Dentist | 36 E Allen St Ste 100, Castle Rock, CO 80108-7823 | 2020-09-09 |
| 1730793803 | Alexis Marie Gerry | Dentist | 13606 Xavier Lane Suite B, Broomfield, CO 80023 | 2020-09-04 |
| 1124632575 | Kristine Villanueva | Dentist | 18620 Green Valley Ranch Blvd, Denver, CO 80249-6843 | 2020-09-03 |
| 1710591342 | Station Dental Group, PC | Dentist | 14001 E Iliff Ave Ste 104, Aurora, CO 80014-1424 | 2020-09-01 |
| 1336751213 | Michael Kawulok | Dentist | 5221 Pinehurst Dr, Boulder, CO 80301-3792 | 2020-08-20 |
| 1699386706 | Westgate Family Dentistry | Dentist | 2323 S Wadsworth Blvd Ste 109, Lakewood, CO 80227-3254 | 2020-08-12 |
| 1801406087 | Victoria Ton | Dentist | 925 S Niagara St Ste 480, Denver, CO 80224-1681 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
| City | PUEBLO WEST |
| Zip Code | 81007 |
Please comment or provide details below to improve the information on COLORADO DENTAL PROFESSIONALS, LLC.
| 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.