Active NPI
Nicolas John Porter, DDS
- Dentist
- Commerce City, CO
National Provider Identifier
1912168436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9687
- Practice address
- 7201 Monaco St
Commerce City, CO 80022-1720 - Phone
- (303) 918-2361
- NPI assigned
- Jun 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 9687 | CO | Primary |
Addresses
Primary practice location
7201 Monaco St
Commerce City, CO 80022-1720
Mailing address
3816 S Dawson St
Aurora, CO 80014-4102
Phone (303) 918-2361
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 |
|---|---|---|---|
| 9687 | CO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryvale Dental Partners LLC | 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.
-
- General Practice Dentistry
- Glendale, AZ
- NPI 1407148026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213747200000",
"number": "1912168436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3816 S DAWSON ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800144102",
"telephone_number": "303-918-2361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7201 MONACO ST",
"city": "COMMERCE CITY",
"state": "CO",
"postal_code": "800221720",
"telephone_number": "303-918-2361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "NICOLAS",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-18",
"last_updated": "2008-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "9687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.