Individual provider Active NPI

Nathan Judd Gillespie II, DMD

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1396494019
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN.00205225 Issued in CO
Practice address
660 Bannock St # L
Denver, CO 80204-4506
Phone
(303) 602-8200
Fax
(303) 602-4560
NPI assigned
Mar 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN.00205225 CO Primary

Addresses

Primary practice location

660 Bannock St # L
Denver, CO 80204-4506

Mailing address

660 Bannock St # L
Denver, CO 80204-4506
Phone (303) 602-8200

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
I20250925004945 CO Practitioner - Dentist 4486159894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Midwestern University College of Dental Medicine, Glendale, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

601 N Broadway
Mc1926
Denver, CO 80203-3407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00205225COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Jun 13, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 13, 2025 Accepting new patients

Locations

301 W 6th Ave
Denver, CO 80204
Phone (303) 602-8070

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: ngillespie266319@direct.dhha.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1396494019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST # L",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "303-602-8200",
            "fax_number": "303-602-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST # L",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "303-602-8200",
            "fax_number": "303-602-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "NATHAN",
        "middle_name": "JUDD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-21",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00205225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.