Aurora Pedo Dental, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

AURORA PEDO DENTAL, PLLC

Practice address

18801 E Hampden Ave Ste 178
Aurora, CO 80013-3587

Phone

(720) 277-5930

Fax

(720) 241-7811

NPI assigned

Aug 26, 2022

Organization subpart

No

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

Authorized official

Name

Colton Flake, DDS

Title

Managing Officer

Phone

(720) 579-8855

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• GRiN Pediatric Dentistry & Orthodontics of Aurora Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1346969730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6870 S UNIVERSITY BLVD",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801221515",
            "telephone_number": "720-399-1227",
            "fax_number": "720-241-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18801 E HAMPDEN AVE STE 178",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800133587",
            "telephone_number": "720-277-5930",
            "fax_number": "720-241-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA PEDO DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "FLAKE",
        "authorized_official_first_name": "COLTON",
        "authorized_official_title_or_position": "MANAGING OFFICER",
        "authorized_official_telephone_number": "720-579-8855",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01928376",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35759046",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44075871",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000182876",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@grinpediatricdentistry.com",
            "affiliation": "N",
            "endpointDescription": "Manager's Email",
            "address_1": "18801 E Hampden Ave Ste 178",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800133587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GRiN Pediatric Dentistry & Orthodontics of Aurora",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRiN Pediatric Dentistry & Orthodontics of Aurora",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Aurora Pediatric Dentistry, Prof. LLC
• Aurora Plastic Surgery, P.C.
• Aurora Professional Massage
• Aurora Psychiatry and Neurology LTD
• Aurora Residential Alternatives, Inc
• Aurora Senior Housing LLC

• Pediatric Dentistry in Aurora, CO
• Providers in Aurora, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.