Marisa A Borchardt, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

00204407 Issued in CO

Practice address

1010 Rio Grande Ave
Montrose, CO 81401-4831

Phone

(970) 497-3333

Fax

(855) 299-7837

NPI assigned

Jun 30, 2020

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

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Olathe Community Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Olathe, CO
  • NPI 1770834244
  Medicare reassignment NPD

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1659998151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 529",
            "city": "OLATHE",
            "state": "CO",
            "postal_code": "814250529",
            "telephone_number": "970-323-6141",
            "fax_number": "855-299-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 RIO GRANDE AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014831",
            "telephone_number": "970-497-3333",
            "fax_number": "855-299-7837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Valley View Dr",
            "address_purpose": "LOCATION",
            "city": "Delta",
            "state": "CO",
            "postal_code": "814163138",
            "country_code": "US",
            "telephone_number": "970-874-8981",
            "fax_number": "855-299-7586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 Main St",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "CO",
            "postal_code": "81425",
            "country_code": "US",
            "telephone_number": "970-323-6141",
            "fax_number": "855-299-8071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORCHARDT",
        "first_name": "MARISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00204407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Wojtkowski Boisen, DDS
• Andrew Bolton, M.D., M.P.H
• William Boniface
• Lois Boomer, OT
• Aliya Boozari, MT
• Douglas Borgo, MD
• Heather Chittenden Borsari, APRN
• Susan L Bothwell, RDH
• Mielle Bottomly
• Victoria Denise Bourgeois, DC

• Dentist in Montrose, CO
• Providers in Montrose, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.