Individual provider Active NPI

Andrea Irarrazabal, D.M.D.

  • General Practice Dentistry
  • Boulder, CO
National Provider Identifier
1497098974
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
00204303 Issued in CO
Practice address
3216 Arapahoe Ave
Boulder, CO 80303-1043
Phone
(303) 442-5000
NPI assigned
Apr 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 059671 NY
General Practice Dentistry 1223G0001X 00204303 CO Primary

Addresses

Primary practice location

3216 Arapahoe Ave
Boulder, CO 80303-1043

Mailing address

3161 Quitman St
Denver, CO 80212-1457
Phone (954) 610-0117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00204303COMDGeneral Practice Dentistry
059671NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gramercy Smiles Past Accepting new patients
Gramercy Smiles Dental General Practice Past Accepting new patients
Boulder Dental Center Arapahoe,P.C PastSince Aug 16, 2020 Accepting new patients

Organizations & group practices 3

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": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1497098974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 QUITMAN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802121457",
            "telephone_number": "954-610-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 ARAPAHOE AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031043",
            "telephone_number": "303-442-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRARRAZABAL",
        "first_name": "ANDREA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-02",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059671",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00204303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.