Active NPI
Jennyfer Delvasto
- Dentist
- Aurora, CO
National Provider Identifier
1215323506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12012584A
- Practice address
- 9856 E Louisiana Dr
Apt 208
Aurora, CO 80247-2390 - Phone
- (479) 531-3459
- NPI assigned
- Apr 13, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12012584A | IN | Primary |
Addresses
Primary practice location
9856 E Louisiana Dr
Apt 208
Aurora, CO 80247-2390
Mailing address
2603 NW 6TH St
Bentonville, AR 72712-3421
Phone (479) 531-3459
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170126000777 | IN | Order and Referring Only - Dentist | 2466734488 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520812800000",
"number": "1215323506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2603 NW 6TH ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727123421",
"telephone_number": "479-531-3459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9856 E LOUISIANA DR",
"address_2": "APT 208",
"city": "AURORA",
"state": "CO",
"postal_code": "802472390",
"telephone_number": "479-531-3459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELVASTO",
"first_name": "JENNYFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-13",
"last_updated": "2018-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12012584A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; 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.