Individual provider Active NPI

Patricia Louise Decino, D.D.S.

  • Dentist
  • Lakewood, CO
National Provider Identifier
1972789741
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7974 Issued in CO
Practice address
950 Wadsworth Blvd Ste 207
Lakewood, CO 80214-4542
Phone
(303) 237-3640
Fax
(303) 237-1522
NPI assigned
Jan 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7974 CO Primary

Addresses

Primary practice location

950 Wadsworth Blvd Ste 207
Lakewood, CO 80214-4542

Mailing address

950 Wadsworth Blvd Ste 207
Lakewood, CO 80214-4542
Phone (303) 237-3640

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213000481 CO Order and Referring Only - DentistPractitioner - Dentist 2567780133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7974COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1972789741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 WADSWORTH BLVD STE 207",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802144542",
            "telephone_number": "303-237-3640",
            "fax_number": "303-237-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WADSWORTH BLVD STE 207",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802144542",
            "telephone_number": "303-237-3640",
            "fax_number": "303-237-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECINO",
        "first_name": "PATRICIA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "7974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.