Colorado Dental Professionals, LLC
NPI 1083706543ActiveOrganization· Dentist· Thornton, CO
Dentist in Thornton, Colorado, registered in NPPES in September 2006, part of Colorado Dental Professionals, LLC. The authorized official on file is Cassandra Petersen, Credentialing Team Lead.
Overview
| NPI | 1083706543 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Colorado Dental Professionals, LLC |
| NPI issued | Sep 29, 2006 |
| Last updated in NPPES | Sep 7, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 6850 | CO |
| Dentist | 122300000X | 0218 | CO |
| Dentist | 122300000X | 104242 | CO |
| Dentist | 122300000X | 105657 | CO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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