Dennis P Driscoll, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105973 Issued in CO

Practice address

318 Orchard Springs Dr
Pueblo West, CO 81007

Phone

(719) 647-1122

Fax

(719) 647-1142

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356430714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 ORCHARD SPRINGS DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "81007",
            "telephone_number": "719-647-1122",
            "fax_number": "719-647-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 ORCHARD SPRINGS DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "81007",
            "telephone_number": "719-647-1122",
            "fax_number": "719-647-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "DENNIS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02105971",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Deana Cuadrado, LMT
• Dana R Bennett MD PC
• Kimberly Davenport, REGISTERED NURSE
• Dental Specialists of Southern Colorado, PC
• Brooke Nicole Deweese, P.A.
• Joanna Driscoll, LPCC
• Shelby Duffey, AGACNP-BC, FNP-BC
• Mary C Edwards, COTA
• Andrew B Emmerman, MD
• Velvet A Entz, BCBA

• General Practice Dentistry in Pueblo West, CO
• Providers in Pueblo West, 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 Jul 8, 2007; 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.