Aaron Degarmo
Individual provider Active NPI Dentist · Bennett, CO
NPI 1194883744 · NPPES record last updated Oct 10, 2019
Key facts
- NPI
- 1194883744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 9784 (CO)
- Practice address
- 280 Colfax Ave., Unit 1
Bennett, CO 80102 - Phone
- (303) 644-5058
- Fax
- (303) 644-5270
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150702000236 | CO | Order and Referring Only - Dentist |
8527370626 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9784 | CO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bennett Dental Center LLC | Past | Accepting new patients |
Interoperability endpoints
- aaron.degarmo@hpchc.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9784 | CO | Yes |
Addresses
Primary practice location
280 Colfax Ave., Unit 1
Bennett, CO 80102
Mailing address
200 Kendall Dr
Lamar, CO 81052-3940
Phone (719) 336-8445
Other providers in Bennett, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.