Active NPI
Adolph Ralph Padula, DDS
- General Practice Dentistry
- Pueblo, CO
National Provider Identifier
1881671436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3209
- Practice address
- 1022 Liberty LN
Pueblo, CO 81001-2039 - Phone
- (719) 545-5778
- Fax
- (719) 545-5783
- NPI assigned
- Dec 26, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 051116 | NY | |
| General Practice Dentistry | 1223G0001X | D-3858 | ID | |
| General Practice Dentistry | 1223G0001X | 22044 | OH | |
| General Practice Dentistry | 1223G0001X | 12010429A | IN | |
| General Practice Dentistry | 1223G0001X | 5641 | OK | |
| General Practice Dentistry | 1223G0001X | 5641 | AZ | |
| General Practice Dentistry | 1223G0001X | 4778T | NV | |
| General Practice Dentistry | 1223G0001X | 60210 | KS | |
| General Practice Dentistry | 1223G0001X | DD2043 | NM | |
| General Practice Dentistry | 1223G0001X | 1134 | WY | |
| General Practice Dentistry | 1223G0001X | 3209 | CO | Primary |
| General Practice Dentistry | 1223G0001X | 21280 | MA |
Addresses
Primary practice location
1022 Liberty LN
Pueblo, CO 81001-2039
Mailing address
415 N Grand Ave
Pueblo, CO 81003-3111
Phone (719) 546-3333
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0204889 | Medicaid | MA | |
| 703167 | Medicaid | AZ | |
| 02551637 | Medicaid | NY | |
| 2525048 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3209 | CO | MD | General Practice Dentistry |
| D-3858 | ID | MD | General Practice Dentistry |
| 12010429A | IN | MD | General Practice Dentistry |
| 60210 | KS | MD | General Practice Dentistry |
| 21280 | MA | MD | General Practice Dentistry |
| DD2043 | NM | MD | General Practice Dentistry |
| 4778T | NV | MD | General Practice Dentistry |
| 22044 | OH | MD | General Practice Dentistry |
| 1134 | WY | MD | General Practice Dentistry |
| 051116 | NY | MD | Pharmacist |
| 5641 | AZ | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1881671436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 N GRAND AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033111",
"telephone_number": "719-546-3333",
"fax_number": "719-546-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1022 LIBERTY LN",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810012039",
"telephone_number": "719-545-5778",
"fax_number": "719-545-5783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADULA",
"first_name": "ADOLPH",
"middle_name": "RALPH",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "051116",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-3858",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "22044",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12010429A",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "5641",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "5641",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "4778T",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KS",
"license": "60210",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NM",
"license": "DD2043",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WY",
"license": "1134",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "3209",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "21280",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0204889",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "703167",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02551637",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2525048",
"state": "OH"
}
],
"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 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.