Individual provider Active NPI

Marina S Protopopova, DDS

  • Dentist
  • Aurora, CO
National Provider Identifier
1396160834
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
00202168 Issued in CO
Practice address
15159 E Colfax Av
Aurora, CO 80011-7600
Phone
(303) 341-5437
NPI assigned
Feb 20, 2014
Last updated
Aug 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 00202168 CO Primary

Addresses

Primary practice location

15159 E Colfax Av
Aurora, CO 80011-7600

Mailing address

2200 N Ursula St
Apt 333
Aurora, CO 80045-7600
Phone (720) 670-9966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180430002227 WI Order and Referring Only - DentistPractitioner - Dentist 5092079988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00202168COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Embracekids V a Professional LLC Past Accepting new patients
Embracekids V a Professional LLC PastSince Oct 27, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1396160834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N URSULA ST",
            "address_2": "APT 333",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457600",
            "telephone_number": "720-670-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15159 E COLFAX AV",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800117600",
            "telephone_number": "303-341-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTOPOPOVA",
        "first_name": "MARINA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.