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PEDO FOUR PROF. LLC NPI 1912238270


NPI Information

NPI: 1912238270
Provider Name: PEDO FOUR, PROF. LLC

Doing Business As: COMFORT DENTAL KIDS - AURORA

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
10401 E COLFAX AVE
SUITE 150
AURORA, CO
ZIP 80010
Phone: (720) 285-7972
Get Directions

PEDO FOUR, PROF. LLC is a pediatric dentistry dentist in Aurora, CO. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. PEDO FOUR, PROF. LLC NPI is 1912238270. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Comfort Dental Kids - Aurora.

The provider's business location address is:

10401 E COLFAX AVE
SUITE 150
AURORA, CO
ZIP 80010-311
Phone: (720) 285-7972
Fax: (720) 241-7811

The provider's authorized official is Colton Flake .
The authorized official title is President and has the following contact phone number (720) 277-5930.

The enumeration date for this NPI number is 1/26/2010 and was last updated on 9/25/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist10630COLORADONo
21223P0221XDentistPediatric Dentistry10630COLORADONo
31223P0221XDentistPediatric DentistryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
165285069MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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