Individual provider Active NPI

Mariella B Connors, DMD

  • Pediatric Dentistry
  • Westminster, CO
National Provider Identifier
1528057619
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DEN.00205516 Issued in CO
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

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
AA20467OtherFIRST SENIORITY
20376OtherDELTA DENTAL
X09081OtherDENTAL BLUE
AA20467OtherHARVARD PILGRIM POS
AA20467OtherHARVARD PILGRIM PPO
0034440OtherNEIGHBORHOOD HEALTH PLAN
20376OtherDELTA DENTAL PREFERRED OPTIO
AA20467OtherHARVARD/PILGRIM

Other names 1

  • Mariella Bonilla Former name

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
DEN.00205516COMDPediatric Dentist
20376MAMDPediatric Dentist
0401418346VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Brendon E. Prestwich, PLLC CurrentSince Sep 3, 2025 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.

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.

Verify at the official NPI Registry.