Active NPI
Daniella Anne Phillis, D.M.D.
- Dentist
- Durango, CO
National Provider Identifier
1588090831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 00202801
- Practice address
- 3057 Main Ave
Durango, CO 81301-4244 - Phone
- (970) 247-5874
- NPI assigned
- Sep 18, 2013
- Last updated
- Nov 18, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1856312 | MA | |
| Dentist | 122300000X | 00202801 | CO | Primary |
Addresses
Primary practice location
3057 Main Ave
Durango, CO 81301-4244
Mailing address
24B Coalbank Dr
Durango, CO 81301-9477
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 |
|---|---|---|---|
| 00202801 | CO | MD | Dentist |
| 1856312 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Smile by Design | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Durango, CO
- NPI 1508173162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479427200000",
"number": "1588090831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24B COALBANK DR",
"city": "DURANGO",
"state": "CO",
"postal_code": "813019477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3057 MAIN AVE",
"city": "DURANGO",
"state": "CO",
"postal_code": "813014244",
"telephone_number": "970-247-5874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIS",
"first_name": "DANIELLA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-18",
"last_updated": "2016-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "1856312",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "00202801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durango, CO
- Philip D Wiley MD PC
- Marjory Lynn Philippon, CLT, RMT
- Rosanna Marie Phillippi, M.A. CCC-SLP
- April Christina Phillips, DNP, FNP-C, PMHNP-BC
- Sarah Phillips, LSW
- Brinceton Michael Phipps, M.D.
- Phoenix Physical Therapy
- Physicians Surgery Center, LLC (ASC Durango at Mercy Regional Medical Center)
- John C Piccaro, MD
- Stephanie Anne Pickren, P.T.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.