Taylor Michael Pedego, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00204922 Issued in CO

Practice address

3025 W 38TH Ave
Denver, CO 80211-2001

Phone

(303) 458-7051

NPI assigned

Jun 25, 2020

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Serenity Dental Arts PLLC

  • Dental Clinic/Center
  • Denver, CO
  • NPI 1184323826
  NPD Authorized official
• Applewood Modern Dentistry, LLP

  dba Applewood Modern Dentistry

  • Dentist
  • Wheat Ridge, CO
  • NPI 1790310951
  NPD (past)
• Dr Mileski DDS PLLC

  • General Practice Dentistry
  • East Wenatchee, WA
  • NPI 1386268829
  NPD (past)

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1205453206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4858 BENTON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802122708",
            "telephone_number": "978-886-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 W 38TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802112001",
            "telephone_number": "303-458-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDEGO",
        "first_name": "TAYLOR",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-25",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61085244",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00204922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pebbles Pediatric Speech Therapy
• Nathan Pecha, OD
• Sanford Dennis Peck, MD
• Anangamanjari Pedapudi, MD
• Chitra Chauhan Peddada, M.D.
• Katherine Pedersen, FNP
• Niels Jonathan Pedersen, D.C.
• Adrienne L Pederson, LCSW
• Pediatric and Adolescent Center
• Pediatric Anesthesia Consultants, PC

• General Practice Dentistry in Denver, CO
• Providers in Denver, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.