Organization Active NPI

SD & JD, LLC

Doing business as Peak Laser & Tattoo Clinic

  • Plastic Surgery Physician
  • Windsor, CO
National Provider Identifier
1992687446
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
SD & JD, LLC
Doing business as
Peak Laser & Tattoo Clinic
Practice address
5916 Bay Hill Court
Windsor, CO 80528
Phone
(970) 988-1446
NPI assigned
Jul 24, 2025
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Justin Divito
Title
Owner
Phone
(970) 988-1446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X NU Primary

Addresses

Primary practice location

5916 Bay Hill Court
Windsor, CO 80528

Mailing address

5916 Bay Hill Court
Windsor, CO 80528
Phone (970) 988-1446

Other names 1

  • Peak Laser & Tattoo Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1992687446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 BAY HILL COURT",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "80528",
            "telephone_number": "970-988-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5916 BAY HILL COURT",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "80528",
            "telephone_number": "970-988-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SD & JD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "DIVITO",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-988-1446"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Laser & Tattoo Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Windsor, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.