Active NPI
Michelle Nguyen
- Pediatric Dentistry
- Superior, CO
National Provider Identifier
1760187819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DEN.00206378
- Practice address
- 306 Center Dr
Superior, CO 80027-8625 - Phone
- (303) 499-9555
- NPI assigned
- Mar 30, 2023
- Last updated
- Aug 6, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DEN.00206378 | CO | Primary |
Addresses
Primary practice location
306 Center Dr
Superior, CO 80027-8625
Mailing address
1040 Santa Fe Dr Apt 1-503
Denver, CO 80204-4354
Phone (520) 789-4636
Other practice location 1
1040 Santa Fe Dr Apt 1-503
Denver, CO 80204-4354
Phone (520) 789-4636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230719003474 | OR | Order and Referring Only - Dentist | 7012377203 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00206378 | CO | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marketplace Dental Group and Orthodontics, LLP | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Marketplace Dental Group and Orthodontics
- General Practice Dentistry
- Superior, CO
- NPI 1750529293
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1760187819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 SANTA FE DR APT 1-503",
"city": "DENVER",
"state": "CO",
"postal_code": "802044354",
"telephone_number": "520-789-4636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 CENTER DR",
"city": "SUPERIOR",
"state": "CO",
"postal_code": "800278625",
"telephone_number": "303-499-9555"
}
],
"practiceLocations": [
{
"address_1": "1040 Santa Fe Dr Apt 1-503",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802044354",
"country_code": "US",
"telephone_number": "520-789-4636",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-30",
"last_updated": "2025-08-06",
"certification_date": "2025-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "DEN.00206378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Superior, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.