Amy Michelle Destaffany, R.D.H., B.S.

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH.000903877 Issued in CO

Practice address

2530 S Parker Rd
Suite 202
Aurora, CO 80014-1623

Phone

(303) 750-2290

NPI assigned

Jul 15, 2014

Last updated

Jul 15, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Michelle Destaffany Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Colorado Dental Professionals, LLC

  dba WaterPark Dental Care

  • General Practice Dentistry
  • Aurora, CO
  • NPI 1235621822
  NPD (past)

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1588071120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 S DOWNING ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802092466",
            "telephone_number": "303-877-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 S PARKER RD",
            "address_2": "SUITE 202",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141623",
            "telephone_number": "303-750-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTAFFANY",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "credential": "R.D.H., B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "DH.000903877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "DESTAFFANY",
            "middle_name": "MICHELLE",
            "credential": "R.D.H., B.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joel Deso, PHA
• Mariamawit Desta, PHARMD
• Rishan Tesfay Desta, MD
• Tigist E Desta, FNP
• Yemane Fitsum Desta, MD
• Destiny Care LLC (Destiny Care)
• Destiny Home Care LLC
• Destiny Internal Medicine PC
• Destiny Medical Supply, Inc.
• Destiny Post Acute Care Services P.C

• Dental Hygienist in Aurora, CO
• Providers in Aurora, CO by specialty
• Dental Hygienist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.