My Local Colorado Dental Practice, LLC
Dentist, General Practice in Aurora, CO. Organization (NPI-2).
NPI number1336726280
StatusActive
Last updated in NPPESMar 26, 2021
Details
- NPI
- 1336726280
- Entity type
- Organization (NPI-2)
- Legal business name
- My Local Colorado Dental Practice, LLC
- Organization subpart
- Yes
- Enumeration date
- Mar 26, 2021
- Certification date
- Mar 26, 2021
- Last updated
- Mar 26, 2021
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 |
Practice location
990 S Abilene StAurora, CO 80012-3686
Phone 720-687-3983
Mailing address
6110 Barnes RdColorado Springs, CO 80922-2600
Authorized official
Michelle Johnson
Credentialing Specialist
5093158338
Is something wrong?
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