Active NPI
Collin Loustalet
- Dentist
- Centennial, CO
National Provider Identifier
1083455067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 182
- Practice address
- 15250 E Orchard Rd
Centennial, CO 80016-3003 - Phone
- (303) 680-9990
- NPI assigned
- Jun 4, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN.00205967 | CO | |
| Dentist | 122300000X | 182 | NE | Primary |
Addresses
Primary practice location
15250 E Orchard Rd
Centennial, CO 80016-3003
Mailing address
17480 E Cloudberry Dr
Parker, CO 80134-8848
Phone (303) 345-1660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 182 | NE | MD | Dentist |
| DEN.00205967 | CO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comfort Dental Parker Road | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Centennial, CO
- NPI 1144398629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1083455067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17480 E CLOUDBERRY DR",
"city": "PARKER",
"state": "CO",
"postal_code": "801348848",
"telephone_number": "303-345-1660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15250 E ORCHARD RD",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "800163003",
"telephone_number": "303-680-9990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOUSTALET",
"first_name": "COLLIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-04",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "DEN.00205967",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.