Individual provider Active NPI

Andrew Comerci, BS, MS

  • General Practice Dentistry
  • Pueblo, CO
National Provider Identifier
1861790792
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN.00010527 Issued in CO
Practice address
1100 Eagleridge Blvd
Pueblo, CO 81008-2103
Phone
(719) 545-2468
NPI assigned
Mar 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN.00010527 CO Primary

Addresses

Primary practice location

1100 Eagleridge Blvd
Pueblo, CO 81008-2103

Mailing address

13065 E 17TH Ave
Aurora, CO 80045-2532
Phone (303) 724-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science, Master of Science

State licenses

LicenseStateTypeSpecialty
DEN.00010527COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Dental Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861790792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13065 E 17TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452532",
            "telephone_number": "303-724-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 EAGLERIDGE BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082103",
            "telephone_number": "719-545-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMERCI",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "BS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00010527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.