Individual provider Active NPI

Maryhen Yohiska Arrieta, D.D.S.

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1265890768
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2026002233 Issued in MO
Practice address
2436 S Academy Blvd
Colorado Springs, CO 80916-2408
Phone
(719) 391-2336
Fax
(719) 391-1625
NPI assigned
Jan 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2026002233 MO Primary
General Practice Dentistry 1223G0001X DEN.00202733 CO

Addresses

Primary practice location

2436 S Academy Blvd
Colorado Springs, CO 80916-2408

Mailing address

4758 Mid Rivers Mall Dr
Saint Peters, MO 63376-2883
Phone (636) 266-2229

Other practice location 1

4758 Mid Rivers Mall Dr
Saint Peters, MO 63376-2883
Phone (636) 266-2229

Other identifiers 1

IdentifierTypeStateIssuer
1265890768MedicaidCO

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170307001359 CO Order and Referring Only - DentistPractitioner - Dentist 5395029540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61313KSMDGeneral Practice Dentistry
RES.004739OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Adventure Vision Parklane LLC Past Accepting new patients
Country Club Dental PA General Practice Past Accepting new patients
Adventure Vision of Topeka LLC Past Accepting new patients
Adventure Vision LLC Past Accepting new patients

Organizations & group practices 4

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": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1265890768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4758 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762883",
            "telephone_number": "636-266-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2436 S ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162408",
            "telephone_number": "719-391-2336",
            "fax_number": "719-391-1625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4758 Mid Rivers Mall Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633762883",
            "country_code": "US",
            "telephone_number": "636-266-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARRIETA",
        "first_name": "MARYHEN",
        "middle_name": "YOHISKA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-29",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2026002233",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00202733",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265890768",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.