My Local Colorado Dental Practice, LLC
NPI 1982258653ActiveOrganization· Dentist, General Practice· Boulder, CO
Dentist, General Practice in Boulder, Colorado, registered in NPPES in July 2019, part of My Local Colorado Dental Practice, LLC. The authorized official on file is Michelle Johnson, Credentialing Specialist.
Overview
| NPI | 1982258653 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | My Local Colorado Dental Practice, LLC |
| NPI issued | Jul 30, 2019 |
| Last updated in NPPES | Jul 30, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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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