Individual provider Active NPI

Prathip Sivaprakasam, DDS

  • Pediatric Dentistry
  • Brighton, CO
National Provider Identifier
1184824922
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DEN-00010504 Issued in CO
Practice address
191 Telluride St Unit 1
Brighton, CO 80601-4356
Phone
(303) 228-0340
Fax
(303) 228-1275
NPI assigned
Jul 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DEN-00010504 CO Primary

Addresses

Primary practice location

191 Telluride St Unit 1
Brighton, CO 80601-4356

Mailing address

2857 Ironton St
Denver, CO 80238-3214
Phone (916) 342-2574

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

LicenseStateTypeSpecialty
DEN-00010504COMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Galaxy Smiles for Kids Pediatric Dentistry CurrentSince Apr 9, 2023 Accepting new patients
Perfect Teeth - Monaco and Evans P.C. General Practice Past Accepting new patients

Locations

191 Telluride St
Unit 1
Brighton, CO 80601
Phone (303) 498-0351

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1184824922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2857 IRONTON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802383214",
            "telephone_number": "916-342-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 TELLURIDE ST UNIT 1",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014356",
            "telephone_number": "303-228-0340",
            "fax_number": "303-228-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAPRAKASAM",
        "first_name": "PRATHIP",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "DEN-00010504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.