Colorado Dental Specialist Practice, LLC
Dentist, General Practice in Denver, CO. Organization (NPI-2).
NPI number1043963697
StatusActive
Last updated in NPPESFeb 2, 2022
Details
- NPI
- 1043963697
- Entity type
- Organization (NPI-2)
- Legal business name
- Colorado Dental Specialist Practice, LLC
- Organization subpart
- Yes
- Enumeration date
- Feb 2, 2022
- Certification date
- Feb 2, 2022
- Last updated
- Feb 2, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Colorado Dental Specialists (Doing Business As)
Practice location
4301 E Amherst AveDenver, CO 80222-6790
Phone 303-758-5858 · Fax 719-213-2311
Mailing address
6110 Barnes RdColorado Springs, CO 80922-2600
Phone 719-266-2717 · Fax 719-213-2311
Authorized official
Gregory Kostelac
Rcm Analyst
7193725605
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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