Organization Active NPI

David J Hayutin DDS Prof LLC

Doing business as Cherry Creek Pediatric Dentistry Prof LLC

  • Pediatric Dentistry
  • Denver, CO
National Provider Identifier
1649271198
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
DAVID J HAYUTIN DDS PROF LLC
Doing business as
Cherry Creek Pediatric Dentistry Prof LLC
Practice address
5055 E Kentucky Ave
Denver, CO 80246
Phone
(303) 757-8844
Fax
(303) 759-0994
NPI assigned
Aug 9, 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, DDSNPI 1831198050
Title
Manager
Phone
(303) 757-8844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 6181 CO Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 915 WY

Addresses

Primary practice location

5055 E Kentucky Ave
Denver, CO 80246

Mailing address

5055 E Kentucky Ave
Denver, CO 80246
Phone (303) 757-8844

Other identifiers 1

IdentifierTypeStateIssuer
83874330MedicaidCO

Other names 1

  • Cherry Creek Pediatric Dentistry Prof LLC Doing business as

National Provider Directory

National Provider Directory

Locations

5055 E Kentucky Ave
Denver, CO 80246
Phone (303) 377-7744

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": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649271198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 E KENTUCKY AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80246",
            "telephone_number": "303-757-8844",
            "fax_number": "303-759-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 E KENTUCKY AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80246",
            "telephone_number": "303-757-8844",
            "fax_number": "303-759-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID J HAYUTIN DDS PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "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": "303-757-8844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "6181",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WY",
            "license": "915",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83874330",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherry Creek Pediatric Dentistry Prof LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, 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.