Michael Ornelas, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

DEN.00202622 Issued in CO

Practice address

4490 W 121St Ave
Ste 7
Broomfield, CO 80020-5602

Phone

(303) 469-2061

Fax

(303) 362-5615

NPI assigned

Aug 21, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Broomfield Modern Dentistry and Orthodontics, LLP

  • General Practice Dentistry
  • Broomfield, CO
  • NPI 1619207594
  NPD (past)

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1912306366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 W 121ST AVE",
            "address_2": "STE 7",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205602",
            "telephone_number": "303-469-2061",
            "fax_number": "303-362-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 W 121ST AVE",
            "address_2": "STE 7",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205602",
            "telephone_number": "303-469-2061",
            "fax_number": "303-362-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORNELAS",
        "first_name": "MICHAEL",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "RR60476044",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optumcare Colorado Medical Group LLC
• Nikole Marie Ordway IV
• Sander H Orent, M.D.
• Orlando Chiropractic Inc
• Dave Orlando, D.C.
• Andrea Elizabeth Ortiz, OTD, OTR/L
• Elizabeth Osborn
• Lynnette Renae Oser, RN, CNOR, BHM
• Osha Healthcare LLC
• Grace Katherine Oviatt, PT, DPT

• Dentist in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.

Verify at the official NPI Registry.