Active NPI
Mariella B Connors, DMD
- Pediatric Dentistry
- Westminster, CO
National Provider Identifier
1528057619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DEN.00205516
- Practice address
- 14697 Delaware St Unit 210
Westminster, CO 80023-9262 - Phone
- (303) 650-0310
- NPI assigned
- Oct 20, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 20376 | MA | |
| Pediatric Dentistry | 1223P0221X | DEN.00205516 | CO | Primary |
| Pediatric Dentistry | 1223P0221X | 0401418346 | VA |
Addresses
Primary practice location
14697 Delaware St Unit 210
Westminster, CO 80023-9262
Mailing address
2809 Eagle Dr
Erie, CO 80516-4002
Phone (857) 654-2321
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AA20467 | Other | FIRST SENIORITY | |
| 20376 | Other | DELTA DENTAL | |
| X09081 | Other | DENTAL BLUE | |
| AA20467 | Other | HARVARD PILGRIM POS | |
| AA20467 | Other | HARVARD PILGRIM PPO | |
| 0034440 | Other | NEIGHBORHOOD HEALTH PLAN | |
| 20376 | Other | DELTA DENTAL PREFERRED OPTIO | |
| AA20467 | Other | HARVARD/PILGRIM |
Other names 1
- Mariella Bonilla
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
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205516 | CO | MD | Pediatric Dentist |
| 20376 | MA | MD | Pediatric Dentist |
| 0401418346 | VA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brendon E. Prestwich, PLLC | Current | Accepting new patients | |
| Ridgeview Pediatric Dentistry PC | Past | Accepting new patients |
Locations
6224 Portsmouth Blvd
Ste 300
Portsmouth, VA 23701
Phone (757) 337-0451
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.
-
- General Practice Dentistry
- Portsmouth, VA
- NPI 1194592717
-
- Dental Clinic/Center
- Westminster, CO
- NPI 1417260787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1528057619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2809 EAGLE DR",
"city": "ERIE",
"state": "CO",
"postal_code": "805164002",
"telephone_number": "857-654-2321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14697 DELAWARE ST UNIT 210",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "800239262",
"telephone_number": "303-650-0310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNORS",
"first_name": "MARIELLA",
"middle_name": "B",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-20",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MA",
"license": "20376",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "DEN.00205516",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "VA",
"license": "0401418346",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST SENIORITY",
"identifier": "AA20467",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "20376",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BLUE",
"identifier": "X09081",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM POS",
"identifier": "AA20467",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM PPO",
"identifier": "AA20467",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0034440",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL PREFERRED OPTIO",
"identifier": "20376",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD/PILGRIM",
"identifier": "AA20467",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARIELLA",
"last_name": "BONILLA",
"credential": "DMD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Westminster, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.