Andrew Lionel Fiscus, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8195 Issued in CO

Practice address

3400 Penrose PL
Suite 202
Boulder, CO 80301-1809

Phone

(303) 442-5748

Fax

(303) 442-5749

NPI assigned

Jul 19, 2005

Reactivated

Apr 11, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902805138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 PENROSE PL",
            "address_2": "SUITE 202",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011809",
            "telephone_number": "303-442-5748",
            "fax_number": "303-442-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 PENROSE PL",
            "address_2": "SUITE 202",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011809",
            "telephone_number": "303-442-5748",
            "fax_number": "303-442-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCUS",
        "first_name": "ANDREW",
        "middle_name": "LIONEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2026-07-13",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Boulder, CO
• Providers in Boulder, CO by specialty
• General Practice Dentistry in Colorado

• 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.

Verify at the official NPI Registry.