COLORADO DENTAL SPECIALIST PRACTICE, LLC (NPI# 1487208013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487208013 |
| Entity Type | Organization |
| Organization Name | COLORADO DENTAL SPECIALIST PRACTICE, LLC |
| Practice Address |
10461 Park Meadows Dr Bldg 4 Lone Tree CO 80124-5306 |
| Practice Telephone | 3035342626 |
| Mailing Telephone | 3035342626 |
| 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 |
|---|---|---|---|---|
| 1518511146 | Colorado Dental Specialist Practice, LLC | Dentist | 18121 E Hampden Ave Unit E, Aurora, CO 80013-3591 | 2019-07-31 |
| 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 |
| Street Address |
10461 PARK MEADOWS DR BLDG 4 |
| City | LONE TREE |
| State | CO |
| Zip Code | 80124-5306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356995021 | My Local Colorado Dental Practice, LLC | Dentist | 10461 Park Meadows Dr Bldg 4, Lone Tree, CO 80124-5306 | 2019-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700413788 | Adam Avant | Student in an Organized Health Care Education/Training Program | Sky Ridge Medical Center 10099 Ridgegate Pkwy, Ste 200, Lonetree, CO 80124 | 2020-03-27 |
| 1265069546 | Nikhilesh Srinivasan | Student in an Organized Health Care Education/Training Program | 10099 Ridgegate Parkway, #200, Lone Tree, CO 80124 | 2020-03-25 |
| 1487281200 | Caden Nowak | Student in an Organized Health Care Education/Training Program | 10099 Ridgegate Parkway #200, Lone Tree, CO 80124 | 2020-03-23 |
| 1427618305 | University of Colorado Hospital Authority | Clinic/Center | 9548 Park Meadows Dr, Lone Tree, CO 80124 | 2019-06-13 |
| 1225505746 | Justin Sean Ashurst | Registered Nurse | 10240 Meadows Dr, Lone Tree, CO 80124 | 2018-11-02 |
| 1396257143 | University Physicians, Incorporated | Family Medicine | 9548 Park Meadows Drive, Lone Tree, CO 80124 | 2017-11-02 |
| 1861928236 | Jennifer Kouri | Student in an Organized Health Care Education/Training Program | 10099 Ridgegate Parkway Ste 120, Rvu/sky Ridge Tri Residency, Lone Tree, CO 80124 | 2017-05-04 |
| 1013443787 | Graham Litchman | Surgery | 1099 Ridgegate Parkway, Graduate Medical Education Office Suite 120, Lone Tree, CO 80124 | 2017-05-02 |
| 1609324466 | Amy Lim | Registered Nurse | 10101 Ridge Gate Pkwy, Lone Tree, CO 80124 | 2016-09-21 |
| 1770933251 | Richard Kenyon French Jr. | Optometrist | 8455 Park Meadows Center Blvd, Lenscrafters At Macy's, Littleton, CO 80124 | 2016-06-15 |
| Find all providers in zip 80124 | ||||
| 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 |
|---|---|---|---|---|
| 1245312990 | Michael J Huber | Dentist | 8683 E Lincoln Ave Ste 210, Lone Tree, CO 80124-9812 | 2006-10-20 |
| 1932289865 | Mark C Lucas | Dentist | 10461 Park Meadows Dr, #101, Lone Tree, CO 80124-5306 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013551530 | Greenwood Village Dental LLC | Dentist | 8000 E Prentice Ave Ste D7, Greenwood Village, CO 80111-2728 | 2019-10-29 |
| 1144878521 | Partners In Periodontics Pllc | Dentist | 1625 Foxtrail Dr Ste 100, Loveland, CO 80538-9089 | 2019-08-29 |
| 1114485331 | Joseph K Will Dds Ms Pllc | Dentist | 10050 W 41st Ave Unit 201, Wheat Ridge, CO 80033-4123 | 2019-03-06 |
| 1215413356 | Brian Lehigh | Dentist | 3400 Penrose Pl Ste 103, Boulder, CO 80301-1809 | 2018-07-12 |
| 1295270916 | Veronica Longville | Dentist | 13533 Huron St Ste 300, Westminster, CO 80234-1160 | 2017-01-04 |
| 1801204532 | Saroj Kumar Saha | Dentist | 682 S Emerson St, Denver, CO 80209-4339 | 2014-07-25 |
| 1053727024 | Mccombs Periodontics LLC | Dentist | 13335 Voyager Pkwy, Suite 130, Colorado Springs, CO 80921-7657 | 2014-07-10 |
| 1992129456 | Daryl Jorge Gasca | Dentist | 6900 W Grant Ranch Blvd, Littleton, CO 80123-5161 | 2014-02-04 |
| 1346663622 | Angie Lee, Dmd, Ms, Pllc | Dentist | 1220 Oak Park Dr Ste 2, Fort Collins, CO 80525-7302 | 2014-01-22 |
| 1629414677 | Colorado Gum Care | Dentist | 899 Hwy 287, Suite 100, Broomfield, CO 80020-7005 | 2013-05-17 |
| Find all providers with the same taxonomy | ||||
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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.