Individual provider Active NPI

Laurence J. Colletti, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Denver, CO
National Provider Identifier
1033300421
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DEN.00006365 Issued in CO
Practice address
660 Bannock St # L
Denver, CO 80204-4506
Phone
(303) 602-8200
Fax
(303) 602-4560
NPI assigned
Aug 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DEN.00006365 CO Primary

Addresses

Primary practice location

660 Bannock St # L
Denver, CO 80204-4506

Mailing address

660 Bannock St # L
Denver, CO 80204-4506
Phone (303) 602-8200

Other practice location 1

1056 S 88th St
Louisville, CO 80027-9460
Phone (303) 666-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210511000335 CO Practitioner - Dentist 4789093402 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00006365COMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Mar 1, 2021 Accepting new patients
Denver Health and Hospital Authority CurrentSince Mar 1, 2021 Accepting new patients
Young Dentistry for Children, LLC Past Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: lcolletti251897@direct.dhha.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1033300421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST # L",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "303-602-8200",
            "fax_number": "303-602-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST # L",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "303-602-8200",
            "fax_number": "303-602-4560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1056 S 88th St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800279460",
            "country_code": "US",
            "telephone_number": "303-666-0800",
            "fax_number": "303-604-2995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLETTI",
        "first_name": "LAURENCE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "DEN.00006365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.