Individual provider Active NPI

Erin Elisa Cettie, DDS

  • Dentist
  • Wheat Ridge, CO
National Provider Identifier
1588929392
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN. 00202120 Issued in CO
Practice address
12495 W 32ND Ave
Wheat Ridge, CO 80033-5288
Phone
(303) 237-2707
NPI assigned
Jul 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 28106 TX
Dentist 122300000X DEN. 00202120 CO Primary

Addresses

Primary practice location

12495 W 32ND Ave
Wheat Ridge, CO 80033-5288

Mailing address

12495 W 32ND Ave
Wheat Ridge, CO 80033-5288
Phone (915) 241-9838

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. 00202120COMDDentist
28106TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cettie-Manzo, DDS, PC General Practice PastSince Jul 24, 2022 Accepting new patients
Tiffany Manzo Jenkins Dentist PastSince Jul 24, 2022 Accepting new patients
Applewood Center for Winning Smiles, P.C. General Practice Past Accepting new patients

Organizations & group practices 3

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": "1341705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1588929392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12495 W 32ND AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800335288",
            "telephone_number": "915-241-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12495 W 32ND AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800335288",
            "telephone_number": "303-237-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CETTIE",
        "first_name": "ERIN",
        "middle_name": "ELISA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28106",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN. 00202120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.