Lilly Anna Poor, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DEN.00205791 Issued in CO

Practice address

421 W 104TH Ave Ste 201
Northglenn, CO 80234-4138

Phone

(303) 872-5970

NPI assigned

Jul 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1720751282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11226 UPTOWN AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800214247",
            "telephone_number": "812-322-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W 104TH AVE STE 201",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344138",
            "telephone_number": "303-872-5970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8960 Westminster Blvd",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CO",
            "postal_code": "800312870",
            "country_code": "US",
            "telephone_number": "720-835-1075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 28th St # 4F",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803011142",
            "country_code": "US",
            "telephone_number": "303-442-4455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOR",
        "first_name": "LILLY",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011155",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00205791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Piernik, LCSW
• Rachel Pinkus, MOT, OTR/L
• Soniya Pokharel
• Julia Christine Polito, O.D.
• Byron Pollock, SA
• Rachael Popejoy
• Emma Porter, DPT
• Whitley Porter, PA-C
• Michelle Portillo, RN
• Anne Leslie Powell, PH.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.