Active NPI
Colton Flake, D.D.S.
- Pediatric Dentistry
- Centennial, CO
National Provider Identifier
1578879417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 10630
- Practice address
- 6870 S University Blvd
Centennial, CO 80122-1515 - Phone
- (720) 277-5930
- Fax
- (720) 241-7811
- NPI assigned
- Aug 30, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 10630 | CO | Primary |
| Dentist | 122300000X | 6068 | NV |
Addresses
Primary practice location
6870 S University Blvd
Centennial, CO 80122-1515
Mailing address
24361 E Roxbury Cir
Aurora, CO 80016-4109
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35759046 | Medicaid | CO |
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 |
|---|---|---|---|
| 6068 | NV | MD | Dentist |
| 10630 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pedo Two, Prof. LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Lakewood, CO
- NPI 1114166865
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1578879417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24361 E ROXBURY CIR",
"city": "AURORA",
"state": "CO",
"postal_code": "800164109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6870 S UNIVERSITY BLVD",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801221515",
"telephone_number": "720-277-5930",
"fax_number": "720-241-7811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAKE",
"first_name": "COLTON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-30",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "10630",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "6068",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35759046",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.