Individual provider Active NPI

Boyd Jeffrey Tomasetti, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Denver, CO
National Provider Identifier
1922063460
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
598 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4597
Phone
(303) 602-5688
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 000598 CO
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 598 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4597

Mailing address

4480 Timber Falls CT Unit 1507
Vail, CO 81657-4877
Phone (720) 289-0574

Other practice location 1

4480 Timber Falls Ct Unit 1507
Vail, CO 81657-4877
Phone (720) 289-0574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927001351 CO Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 0648161885 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000598COMDOral and Maxillofacial Surgery (Dentist)
598COMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince May 4, 2016 Accepting new patients
Denver Health and Hospital Authority CurrentSince May 4, 2016 Accepting new patients
Rocky Mountain Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: btomasetti32955@direct.dhha.org

Organizations & group practices 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1922063460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 TIMBER FALLS CT UNIT 1507",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816574877",
            "telephone_number": "720-289-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-602-5688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4480 Timber Falls Ct Unit 1507",
            "address_purpose": "LOCATION",
            "city": "Vail",
            "state": "CO",
            "postal_code": "816574877",
            "country_code": "US",
            "telephone_number": "720-289-0574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMASETTI",
        "first_name": "BOYD",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "000598",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.