NPIMap

Organization Active NPI

Aurora Pediatric Dentistry, Prof. LLC

  • Pediatric Dentistry
  • Aurora, CO
National Provider Identifier
1609875830
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6181 Issued in CO
Legal business name
AURORA PEDIATRIC DENTISTRY, PROF. LLC
Practice address
5657 S Himalaya St
Ste 200
Aurora, CO 80015-5307
Phone
(720) 886-0808
Fax
(720) 886-0994
NPI assigned
Jul 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Joel Hayutin, DDS
Title
Manager
Phone
(720) 886-0808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 6181 CO Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 915 WY

Addresses

Primary practice location

5657 S Himalaya St
Ste 200
Aurora, CO 80015-5307

Mailing address

5657 S Himalaya St
Ste 200
Aurora, CO 80015-5307
Phone (720) 886-0808

Other identifiers 1

IdentifierTypeStateIssuer
38006219MedicaidCO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609875830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5657 S HIMALAYA ST",
            "address_2": "STE 200",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800155307",
            "telephone_number": "720-886-0808",
            "fax_number": "720-886-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5657 S HIMALAYA ST",
            "address_2": "STE 200",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800155307",
            "telephone_number": "720-886-0808",
            "fax_number": "720-886-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA PEDIATRIC DENTISTRY, PROF. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYUTIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "720-886-0808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "6181",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WY",
            "license": "915",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38006219",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.