Blue Mesa Dentistry at Southglenn
NPI 1881747319ActiveOrganization· Dentist· Centennial, CO
Dentist in Centennial, Colorado, registered in NPPES in January 2007. The authorized official on file is Marissa Anne Nicholson, Office Manager.
Overview
| NPI | 1881747319 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 19, 2007 |
| Last updated in NPPES | Aug 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 6372 | CO |
| Dentist | 122300000X | 6619 | 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 |
|---|
Other Dentist providers in Centennial
- 1366829830
- 1033668140
- 1649450180
- 1689092058
- 1689145609
- 1588870869
- 1821914532
- 1083048185
- 1376967927
- 1003220476
- 1396071643
- 1669930319