Organization · Type 2 NPI

Colorado Dental Specialist Practice, LLC

Periodontics · Denver, CO

NPI number 1790339323 Active

Practice location

200 Quebec St Unit 105
Denver, CO 80230-7144

Specialties and licenses

Taxonomy	Code	License
Endodontics	1223E0200X	None listed
Periodontics Primary	1223P0300X	None listed
Orthodontics and Dentofacial Orthopedics Dentistry	1223X0400X	None listed

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.

3 other providers at this address

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NPI record

NPI: 1790339323
Entity type: Organization (Type 2)
Issued: Jul 31, 2019
Last updated: Jul 31, 2019
Status: Active
Subpart: Yes of Colorado Dental Specialist Practice, LLC

Other names

Colorado Dental Specialists · doing business as
Colorado Endodontic Group · doing business as
Colorado Orthodontic Group · doing business as

Authorized official

Michelle Johnson
Credentialing Specialist
(509) 315-8338

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1790339323

Colorado Dental Specialist Practice, LLC's National Provider Identifier is 1790339323, issued on Jul 31, 2019. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Denver, CO. The record was last updated on Jul 31, 2019.