Organization Active NPI

Lodo Dental PC

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1255543393
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8980 Issued in CO
Legal business name
LODO DENTAL PC
Practice address
1435 Wazee St Ste 102
Denver, CO 80202-1491
Phone
(303) 623-5636
Fax
(303) 623-5640
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Authorized official

Name
Nicole Kikue Furuta Griffith, DDS
Title
Owner
Phone
(303) 623-5636

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 8980 CO Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

1435 Wazee St Ste 102
Denver, CO 80202-1491

Mailing address

1435 Wazee St Ste 102
Denver, CO 80202-1491
Phone (303) 623-5636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719002964 CO DME Supplier - Oral Surgery - Dentist 1759741937 Practice locations: Denver, CO

National Provider Directory

National Provider Directory

Locations

1435 Wazee St
Ste 102
Denver, CO 80202
Phone (303) 623-5636

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1255543393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 WAZEE ST STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021491",
            "telephone_number": "303-623-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 WAZEE ST STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021491",
            "telephone_number": "303-623-5636",
            "fax_number": "303-623-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODO DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "KIKUE FURUTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-623-5636",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8980",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.