Individual provider Active NPI

Geoffroy Destenaves, DMD

  • Dentist
  • Thornton, CO
National Provider Identifier
1043759384
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00203573 Issued in CO
Practice address
8990 Washington St
Thornton, CO 80229-4537
Phone
(720) 929-1655
Fax
(720) 565-4129
NPI assigned
Feb 20, 2017
Last updated
May 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00203573 CO Primary

Addresses

Primary practice location

8990 Washington St
Thornton, CO 80229-4537

Mailing address

1735 S Public Rd Ste 203
Lafayette, CO 80026-7093
Phone (303) 665-3036

Other practice location 1

301 W 6th Ave
Denver, CO 80204-5182
Phone (303) 436-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address geoffroy.destenaves.p4@direct.clinicafamilyhealth.nextgenshare.com Direct

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
I20220217000545 CO Practitioner - Dentist 0648663591 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00203573COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Feb 8, 2022 Accepting new patients
Peak Vista Community Health Centers CurrentSince Feb 8, 2022 Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

2828 International Cir
Ste 140
Colorado Springs, CO 80910
Phone (719) 344-7131

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

Interoperability endpoints

  • Direct secure messaging: geoffroy.destenaves.p1@direct.peakvista.nextgenshare.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1043759384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 S PUBLIC RD STE 203",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267093",
            "telephone_number": "303-665-3036",
            "fax_number": "303-665-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 WASHINGTON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294537",
            "telephone_number": "720-929-1655",
            "fax_number": "720-565-4129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802045182",
            "country_code": "US",
            "telephone_number": "303-436-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESTENAVES",
        "first_name": "GEOFFROY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-20",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00203573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "geoffroy.destenaves.p4@direct.clinicafamilyhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGen EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "8990 Washington St",
            "city": "Thornton",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802294537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.